Why are all my doctors overdiagnosing me with things I don't have?
January 17, 2012 7:09 AM   Subscribe

I feel that my doctors are overdiagnosing me - psychiatrists, specialists, and even pcps. I feel like a lab rat or a trophy case for them - "here's one of my patients, she encompassed the entire diagnostic manual, ha ha!" What's going on?

I see three doctors currently: my primary doctor (physician) whom I've seen for all 18 years of my life, my psychiatrist, whom I've seen for a year and whom I detest with all my being, and a gynecologist, whom I saw a few months ago to go on birth control because of my extremely uncomfortable periods.
My psychiatrist I've always known to be diagnose-crazy. Every week I went in, I was diagnosed with something new. First it was depression after I tried committing suicide. I was sent to a psychiatric hospital where they further diagnosed me with social anxiety with agoraphobia, obsessive-compulsive disorder, and panic disorder. When I returned to my normal psychiatrist, it began a long year of being diagnosed with something new every week - and prescribed medications for these new disorders.
My complete list so far (in chronological order): major depression, social anxiety, agoraphobia, OCD, Bipolar 1 with psychotic symptoms, Bipolar 2, borderline personality disorder, schizoid personality disorder, Asperger Syndrome, and Attention Deficit Disorder. All of these are on my medical record, forever, along with the three psychiatric hospitalizations that I've been to after being diagnosed.
My initial depression was situational - I had been broken up with long-distance for the first time, and I didn't know how to handle it. Over the next few months, I got over it. But this psychiatrist wouldn't stop. I've been on so many medications that the half-empty bottles are overflowing my counter. Lithium, Prozac, Klonopin, Buspar, Concerta, Seroquel, Risperdal - I feel like I have my own pharmacy. I've been seeing this shrink for over a year, and every visit comes with a new diagnosis and a new prescription. I'm sick of it. I feel like a lab rat - "let's put this strong chemical inside you for something you probably don't have and see what happens." Bad things have happened every time. Prozac made me try to kill myself. Klonopin gives me amnesia. Lithium made me sleepwalk. Concerta makes me feel like I'm having a heart attack. After one round of the medication, we switch to a wholly unrelated diagnosis.
It doesn't stop with psychiatry. Recently I've been on the birth control pill to control my heavy, painful menstruation. I missed a pill before Christmas and my period started. It has not stopped since. It's been going for almost a month. One doctor said it was simply mennoraghia that would subside as I kept taking the pills. One doctor said it was a blood disease called von Willebrand's. Now my primary doctor is saying it's an eating disorder. I do not have an eating disorder. I eat every other day because we don''t have enough food to eat three meals a day. I don't binge. I don't purge. it's all bullshit to me.
I feel like these doctors are after me. I feel like they see me as an experiment. "Does she have a symptom of this disease sometimes? well she must have the disease. Medicate her." "What haven't I diagnosed her with yet that I can get away with doing today?" I'm so sick of it. I've looked around for other doctors but none of them are taking new patients. I'm trapped. The doctors always call my mom and tell her what I've been diagnosed with. I am the last person to know, even though I'm an adult and should be the first to know. all of this seems unethical to me and it's breaking me down. There's no way I have all of these things, but hearing constantly that I do is destroying me.

The question: is this common practice for doctors? Has anybody ever experienced these trains of diagnoses that never, ever end? What should I do? I can't take much more of this. it's breaking me and I feel subhuman, like I'm just a game piece for these doctors. I just don't know what to do but I have to do something, because internally it's destroying me completely and I know from experience that it's only a matter of time before I completely break and end up in another ward, where this time they'll diagnose me again without even talking to me. I need out of this. I've been in it for years and I need out, or at least an explanation as to why this is happening.
posted by anonymous to Health & Fitness (26 answers total) 13 users marked this as a favorite
I think you need to switch psychiatrists. You are not required by law to keep the same psychiatrist, and if one is over-treating you and raises so many red flags, you are the only person who can stop this other person (doctors are people...I know that sounds simplistic, but sometimes patients elevate them to a status where they don't feel empowered to make their own decisions concerning their own care) from doing so. Seek another opinion. You're at least 18 (from your pcp description), so if it was the case that you followed what your parents said, re: physicians, you're not obligated to do so anymore.
posted by xingcat at 7:18 AM on January 17, 2012 [5 favorites]

First, it seems like you really need to find another psychiatrist. As someone who's been to quite a few myself, it's very important that you like them and accept what they have to say. In this case, it doesn't seem like you either like your therapist, or that's he/she's actually helping you at all.

I eat every other day because we don''t have enough food to eat three meals a day.

This was something that caught my eye. I am not a doctor am have no idea if this is causing the issues with your period. However, eating every other day (as in, I assume you mean you go for over 24 hours without food regularly?) is really not healthy. I doubt that it provides your body with enough fuel to go on without making you feel crap. Even if you don't have enough food to eat several times a day maybe try spacing a big meal and snacks at least once a day?
posted by Trexsock at 7:18 AM on January 17, 2012 [14 favorites]

Do you actually need to see a psychiatrist? If the treatment is worse than the problems you went in for...then stop seeing the psychiatrist (don't just stop taking the meds...work with a doc to make sure you're on a reasonable number and dose, stepping down doses as necessary). It's not unheard-of to receive multiple diagnoses, especially as more symptoms come to light...but it sounds like you're actually receiving some conflicting diagnoses without anyone clarifying for you what they think is actually going on.

Psychiatry isn't an exact science (to say the least), and it often involves switching meds and dosages to try to have an effect...but sometimes you need a (supervised, careful) break from that. Are you in therapy at all, or are your issues only being addressed via meds?
posted by mittens at 7:21 AM on January 17, 2012

This is the only part I feel I can comment on:

Now my primary doctor is saying it's an eating disorder. I do not have an eating disorder. I eat every other day because we don''t have enough food to eat three meals a day.

If the reason for your problem is that you're not eating enough, the particular reason that you're not eating enough doesn't matter much. Your doc may be on to something. Try not to dismiss it just because his understanding of your situation is incomplete and you feel judged.
posted by jon1270 at 7:21 AM on January 17, 2012 [19 favorites]

major depression, social anxiety, agoraphobia, OCD, Bipolar 1 with psychotic symptoms, Bipolar 2, borderline personality disorder, schizoid personality disorder, Asperger Syndrome, and Attention Deficit Disorder

Definitely don't be shy about seeing a different psychiatrist. This is America-- YOU get to make your own choices about your health and your doctor. However, there is a lot of symptomatic overlap between many of these conditions, and they can be hard to differentiate. The treatment is different depending on the condition, even though the symptoms may be similar. Your doctors are trying to figure out what the underlying condition is, and that's not easy.

Honestly, it would be more worrisome if your psychiatrist said, "you have condition X, here's a prescription, come back once a month to check in and refill the prescription," while you realized that you weren't getting better and the doctor wasn't doing anything about it.
posted by deanc at 7:31 AM on January 17, 2012 [1 favorite]

You can always see a second doctor for another opinion if you feel the first one is fishy, and you can always push back if you feel uncomfortable with the treatment plan you're given. Especially if the treatment plans are so not-working that the stress itself endangers your mental health.

Keep searching for new doctors, even ones out of town that you might have to drive awhile to get to. Ask your primary doc for referrals to a new psychiatrist and gynecologist. Call your insurance and see if they can give you referrals. Try visiting a psychologist or counselor; medication is not likely to be their first recourse as it is for some psychiatrists and they might be able to point you to better psychiatrists. You're nearing a crisis point, so your number one concern in your life right now should be finding new doctors. Not all doctors are the same, so set up screening appointments for a few of them and go with the one you get the best vibe from. It will be time consuming and probably expensive, but not as expensive as if you end up back in another ward.

When you find new doctors, you need to be more assertive with them and advocate for yourself. Know what you'd like to get from treatment, whether it be "I don't want these mood swings anymore," or "I want these racing thoughts to stop." Tell them, "here are my symptoms, here are my goals, and ideally I'd like to achieve them with as few medications as possible." When they give you a diagnosis or prescription, ask questions -- how will it help you achieve your treatment goals, what are the side effects, how will I know if it's not working, what's the adjustment time, why this particular medication over something else? Take notes if that will help you remember. If they don't tell you these things during the appointment, then make the next appointment about asking those questions.

Does your mom know how the doctors' attitudes are affecting you? Recruit her into helping you become an active participant in your treatment. When doctors call her instead of you, have her request that they call you as well. Maybe bring her into the doctors' office at the end of the appointment so you can all have the conversation at the same time. They may initially talk to her instead of you for awhile, but that will change the more you advocate for yourself.

With that being said, medical treatment can sometimes take a long time to pin down and mental health is no exception. Sometimes the process involves a lot of false turns and dead ends, and that is totally to be expected. Sometimes medication is the only option and you have to burn through a couple different ones before you find one that works. Don't dismiss everything out of hand, but talk with your doctor openly about your hesitance and anxiety. Good doctors will make you feel as comfortable as possible, by either changing the treatment plan or explaining why this specific one is necessary. But if they don't know how unhappy you are they can't help you fix it.
posted by lilac girl at 7:40 AM on January 17, 2012

My husband's recently been reading Overdiagnosed: Making People Sick in the Pursuit of Health... Might be a good one to check out.
posted by mgogol at 7:55 AM on January 17, 2012 [1 favorite]

If you see a new physician or psychiatrist, I recommend printing out your post and sharing it with him/her.

Preface it with "this is me being a bit ranty ---- but I'm really worried about how to approach all this and still feel hopeful".

When you start with someone new, they need to know your perspective on your history. Don't try to start with a "blank slate" without sharing the history, which might be tempting. The answers lie in a partnership with you, not in a new "unbiased, objective opinion."

You could also bring a sanitized version of this post to your current care providers, reframing your harshest criticisms that allege bad motives. (There's nothing wrong with what you say here, its just that you're in a vulnerable position and you want them on your side.) Something along the lines of "I'm starting to feel overdiagnosed and under-relieved."

Going without food may be making you very emotional (labile) and may change your body's response to the medications. If you don't have access to food everyday, that may be the first thing you need help with.
posted by vitabellosi at 8:03 AM on January 17, 2012 [2 favorites]

What is your support system like? Do you have friends or other relatives to talk to? It sounds like you need to figure out a way to dial back your medical interventions.

What is the situation with your family that means you only have food every other day? If you're getting medical care via a state program (which I assume, since I imagine if your family can't afford daily meals then they don't have insurance?) your family should qualify for food stamps. Believe me, no matter how dandy you think you're doing on half rations, it's affecting your overall health and functioning. Being adequately fed will help you to sleep and help you to think so that you can separate out what needs treatment from what will just respond to food and rest.

Why do you have to go to the psychiatrist that you hate? Why do you have to take the meds? Are your parents forcing you to go? Is there any way to change doctors or are you restricted by location or healthcare program as to who you can see?

It sounds like you're mixing really heavy duty meds - or at least taking them close together - which can't be good.

Doris Lessing, a British writer, talked about some stuff with the psychiatry like you've described - her experience was in the sixties (and her friends') but she too talked about getting a new diagnosis every time, and being pushed toward explanations for her situation that didn't make any sense to her. Her semi-autobiographical writing is in multiple books, but what I'm thinking of is in a rather strange novel called The Four-Gated City. It might not be your thing at all - but anyway, what you report isn't unique.

Have you heard of the Icarus Project? The website is pretty hippie and woo and "madness is a gift", but a bookstore where I used to work stocked the actual zines and books, and they're good, plus I've met actual people involved with the project and they're fairly solid. You don't have to believe in the big framework of "yay, we're crazy and brilliant!!!" to get something out of the resources.
posted by Frowner at 8:03 AM on January 17, 2012 [2 favorites]

I feel that psychiatrists tend to massively over-diagnose and over-medicate, I've been on ridiculous amounts of medications I didn't need, with very little evidence that they should be prescribed to me. You need to be your own advocate. The best approach you can take is educating yourself about your symptoms and the available medications. Diagnoses are just labels for collections of symptoms. Make a list for yourself, and to show your doctors, of what symptoms you actually have and want treatment for. You can refuse any medication prescribed for you, and can and should research every medication before taking it. I have had very good results researching medications on my own, reading other people's experiences with them, and then bringing it up to my doctor. If you can discuss it intelligently with them, they are more likely to take you seriously. And remember, some doctors just aren't very good at what they do, or take the easy way out. Keep looking for a different psychiatrist, yours sounds like a bad match.

Also, it is totally illegal for your doctor to call your parents without your permission when you are an adult. You need to get a new doc, and explicitly tell them that is is not acceptable for them to discuss your medical information with anyone else.
posted by catatethebird at 8:22 AM on January 17, 2012

Do you live with your mother? If so and your mother thinks it's ok to eat only every other day then she is abusing you and you need to get away from her. Eating every other day is something that only normally occurs in extreme situations like wars or famines. How long has this terrible eating pattern been going on? I'm a mother. I'd be out on the street begging if I couldn't find any other way to make sure my child ate every day, even one as old as 18.

Rather than medical help it sounds like you need social help, help finding a better living situation, help acquiring sufficient food, and a competent caring therapist who will help you untangle all of this. Psychiatrists these days are primarily about drugs, you need another kind of therapist.

I feel for you and really hope you feel better soon.
posted by mareli at 8:25 AM on January 17, 2012 [9 favorites]

If you're an adult and your docs are sharing info with your mom, there's either a legal custody sort of thing in place, or you've signed paperwork authorizing them to share information about your care with her, which can be revoked. (Or your mom may not be telling you the truth. )

Privacy laws are quite strict. Docs take the laws very seriously because the penalties for violating them are very serious.

posted by vitabellosi at 8:29 AM on January 17, 2012 [3 favorites]

First off, not all medication works the same on all people. It is common for a psychiatrist to change medications until one fits. But, you hate your psychiatrist, so you do need to find another one. Mental health requires a partnership between you and your doctor. This is clearly not happening. Talk to your primary care doctor (who has known you all your life) and ask for his opinion on the diagnoses and the medication. Ask him to refer you to a different psychiatrist, if possible.

Now, for the eating disorder part. You may not have an eating disorder but you do have the results of having one, because you are not eating every day. You have to eat every day, 3 meals a day.

Wherever you are in the world there are people to help with this. Get government assistance, go to food banks, ask a local church. You have to eat. This is not optional.

Your bleeding may be caused by nutritional deficiencies, side effects from medications or something else. You may have developed polyps, which are harmless but can cause bleeding and need to be removed. If the bleeding continues, you must go see the doctor. Continued bleeding such as you have been experiencing can cause anemia. Poor eating can cause anemia. You will need to be tested for this and if you are not already taking iron supplements then you should start right away.
posted by myselfasme at 9:17 AM on January 17, 2012 [5 favorites]

Are you seeing a therapist in addition to your psych? That may help with the multiple diagnosis issue-a psych that sees you for 15 minutes once a month can't really get into your thought processes and behaviors like a therapist can, so they sort of have a scattershot approach to meds. Going on what little bit you can tell them in a short appt time, they sort of throw something at you to see if it works, next month if you aren't better, they try something else.

The diagnosis issue might also be due to insurance coding. Some things are/aren't covered depending on the diagnosis code used when the claim is submitted to the insurance company. It's not uncommon for claims to be sent back to the provider, a different code slapped on it, refiled and then paid.

Find another psych, preferably one familiar with your therapist (if you have one) and try a team approach, rather than 3 different cooks in one pot.
posted by hollygoheavy at 9:51 AM on January 17, 2012

Response by poster: Now my primary doctor is saying it's an eating disorder. I do not have an eating disorder. I eat every other day because we don''t have enough food to eat three meals a day. I don't binge. I don't purge. it's all bullshit to me.

This is a really tough situation. Food deprivation causes not just serious physiological effects--which you may be experiencing--but psychological as well. There is some conflict in the ED-treatment community over the issue of force-feeding (like through a tube) anorexics, because on the one hand it causes negative effects by taking away the patient's sense of control (and EDs are often a response to a loss of control), but on the other hand someone starving and nutrient-deprived may actually starve themselves more because the depression, etc exacerbated by starvation leads to a feedback loop. Whether or not you have an ED may be irrelevant because the side-effects are the same.

If you live in the US, have you looked into applying for food stamps or getting food from local pantries? If you're in a financial situation so bad that you can only afford food every other day, then you should surely qualify. There is also emergency cash assistance programs set up for situations like this.

Food is a most basic survival need . . . if you're totally unwilling to consider assistance with this, do ask yourself why.

Also, the only reason your doctors would be sharing medical info with your mom is if you had signed papers giving her the right to, or if she'd been legally declared your guardian or something. Otherwise it's a serious legal breach and you should really investigate the reasons why they're doing this.
posted by Anonymous at 10:03 AM on January 17, 2012

These two statements raised flags for me:

I eat every other day because we don''t have enough food to eat three meals a day

Why is this? You're able to see a psychiatrist, get meds, get birth control pills, get the internet. Why is food 3x a day unavailable? There's government assistance. There should be churches or community services in your town who provide food.

The other flag was raised by this:

I know from experience that it's only a matter of time before I completely break and end up in another ward

Experience separate from the suicide attempt you mentioned? Is there history of you being hospitalized for psychiatric reasons?

I'm really curious what role your mother is playing in all of this. No food. Hospitalization. Lots of meds. Doctors call her, not you. Because Munchhausen by proxy comes to mind.
posted by vivzan at 10:04 AM on January 17, 2012

I don't want to be too harsh about this, but I don't really believe you. I'm sure you're frustrated, and I'm sorry you feel so out of step with your providers, but I don't believe your implication, which is that essentially all these things are happening for no good reason. You've had three psych hospitalizations in the past year, at least one for a suicide attempt. Regardless of your displeasure, something substantial is going on here. When we take account of some of the other elements of your story, like your bizarre explanation for your eating pattern, your story starts to look suspect.

That doesn't mean you don't have the right to be frustrated, or to find another doctor you like better. By all means, look for another doctor. But, reading between the lines, it seems like this is all a developing set of mental issues and it may well take a while to get a solid diagnosis. Likewise, your bleeding seems to be a developing issue that might take some time to diagnose. But, there's nothing that you've written that makes it seem like you're being mistreated. Certainly no one in the Internet can determine if you are. Another doctor, however, might be able to help.
posted by OmieWise at 11:10 AM on January 17, 2012 [28 favorites]

Stop seeing all these doctors and use the money you save to eat some food
posted by MangyCarface at 11:25 AM on January 17, 2012

You've got two different situations going on, and you're conflating them into one. I can understand why you are doing that, because it can be tough when you're seeing a lot of different doctors, and many don't speak in everyday non-jargon terminology that you can understand, so it can seem like they're saying a lot of different things, when really they're saying variations on the same thing.

As far as the psychiatry situation goes, you've had a lot of good comments already about that, but I have to agree with the concern that there is something that doesn't add up about your situation. First would be your assertion that it's normal only to eat every other day, which is tough to reconcile (also you say you don't binge and purge as evidence, when clearly your eating pattern is more compatible with anorexia, which doesn't involve binging or purging). Then you say that you only had a situational depression and you've gotten over it. I find it hard to believe that you have no psychiatric issues right now but yet you're still going to psychiatry appointments regularly, getting all sorts of different diagnoses, and taking many different medications. It doesn't sound like anyone is forcing you to do these things. If you don't have a psychiatric issue, why don't you stop going to the psychiatrist? Stop taking the psych medications? I'm not being sarcastic here, I'm truly wondering.

The second, different situation is with your abnormal menstrual bleeding. The first doctor told you that it was menorrhagia. It is. That is a symptom, not an underlying cause. Another doctor said it was von Willebrand's - I suspect this was just a diagnostic possibility, because von Willebrand's is not a clinical diagnosis. Either you have it, and you have a low level of von Willebrand factor in your blood, or you don't. It can be confirmed. The last thing you mention is an eating disorder. It is true that your diet can affect your menstrual cycle, although it is more typical that if you aren't getting enough nutrition/are anorexic, you won't get your period at all. It sounds like you missed a pill that was probably a low estrogen pill, and that threw your system out of whack. That is a common problem with low dose estrogen pills. The treatment is oftentimes to try temporarily adding additional estrogen, or to use anti-inflammatories (NSAIDs). p.s. IANYD.

tl, dr: Remember that medicine is an art, and that not all diagnoses are easy to make. Don't confuse discussion of symptoms or diagnostic possibilities (the "differential") with an actual diagnosis. And yes, psychiatrists can over-diagnose, but they don't have lab tests to work with to make their diagnoses: they do it based on what you tell them. So think hard about what you're telling them.
posted by treehorn+bunny at 11:26 AM on January 17, 2012 [5 favorites]

I'm sorry you're so clearly unhappy with things at the moment, but I'm glad that it sounds like there are people around who care for you and who are trying to help you - you may feel that you're fine, but it sounds like they don't think you are, just yet. Three hospitalisations would also suggest otherwise to this internet stranger. I know from talking to friends, who have had siblings with mental health issues who were in grave danger of harming themselves or being harmed by the situations they put themselves into, how hard it can be to get people into hospitals for treatment, so I get the feeling it isn't something that happens lightly. Depression and its ilk can give us a distorted view of who we are and how well we are sometimes. And other forms of mental illness can be even worse - people think they're fine and it's everyone else who is wrong, but just don't see how warped their thinking is at that time (and this isn't a criticism, it's how mental illness plays out sometimes).

What do YOU think is wrong with you? Given that you have acknowledged the situational depression and associated suicide attempt, why do you think the doctors and your psychiatrist are continuing to treat you? I know you will say you are not a medical professional, but you must have a sense of what is happening to / with you that is causing all these people to want to continue to treat you.

I also thought if you were eating so infrequently, that might be affecting the effectiveness of some of the drugs you're being prescribed, to the point where they're not having the positive effects the psychiatrist is expecting (hence them frantically casting around for other treatments).

What does your mom say about what's going on? I know you're 18, but it seems like she's still involved in your situation quite heavily - does she agree with the lines of treatment being offered you? Like treehorn+bunny, I wondered why, as at 18 you presumably have the authority to do so, you don't just say you want to explore a different approach to your treatment - or if you don't believe you are in need of it, why you don't say no?

Is there a part of you that feels somehow safer in the situation you're in, annoying to you though it is, than if you were dealing with your situation on your own without medical help? I sense that you are (perhaps understandably) scared of this lack of what you feel to be an "acceptable" diagnosis, but might it be that you've already had the "right" diagnosis but for whatever reason you are having trouble accepting it? I am only asking the question because we all do this at times - we don't like what we've heard so we keep asking and questioning and hoping to find another way out of the hole, but sometimes there's only the same old ladder right in front of us.

What to do? I'm sure you have already, but why not try engaging with the doctors and psychiatrist and ask the questions you need answers to, and politely but firmly keep asking them until you understand. Can your mom advocate for you, or is there someone else you trust who could help you with this? If you really feel your psychiatrist is someone you can't work with, then ask for a change. You have a role in this process, too - you are not without choice or agency in this; you can choose to commit to doing whatever it takes to help yourself up the ladder, be that talking to the professionals, getting more appropriate amounts of fuel into your body to help it heal itself or just thinking about where you are and where you want to be.

I wish you well.
posted by Martha My Dear Prudence at 1:03 PM on January 17, 2012

I do not have an eating disorder. I eat every other day because we don''t have enough food to eat three meals a day.

This is absolutely horrendous for your body. Seriously, eating three half-meals a day, or two half-meals a day, is much better for your digestive and endocrine systems than eating two or three full meals one day and fasting the next day.

Unless it's that your financial situation is so dire that you're eating at soup kitchens on the "eating" days and not eating on the other days because you have no access to soup kitchens on those days--and if that is so, I am heartbroken to hear that, and would encourage you to ask the soup kitchen staff if they have a "food pantry" program or know of any in the area--what you're doing may well be disordered eating, inasmuch as you might be prioritizing a feeling of sateity or satisfaction over what is the more health-conscious approach of spreading the food you have out so that you can eat every day.

Please reconsider your approach to eating. Obviously, my greatest wish for you and for your family is that you can all get your nutritional needs met in full every day, but if that isn't possible, eating something every day is really important, and more beneficial than food cycling. If you can possibly make that happen, there is every likelihood that your body and your brain will respond better to your medications and treatment plans.

Best of luck to you. You will be in my thoughts.
posted by Sidhedevil at 1:22 PM on January 17, 2012 [2 favorites]

people think they're fine and it's everyone else who is wrong, but just don't see how warped their thinking is at that time

Yes, and, not to be harsh, but your thinking is warped, as evidenced by the blase way you toss out the information that you eat only once every other day as if that were normal. Notice how many posters above latched onto that one line. Honestly, if I were you, I'd make it priority #1 to start eating regularly, and then move on to dealing with the secondary issues. At this point, you don't even have a proper baseline for evaluating your mental or physical health. You're disregarding the most fundamental thing humans need to function properly (apart from air to breathe), which is sustenance.

Caveat: If you are at a crisis point and, god forbid, become suicidal again, then that of course becomes priority #1. But you should recognize how a base-level failure to take care of your body can contribute to a your reaching crisis point.
posted by torticat at 1:24 PM on January 17, 2012 [9 favorites]

I think the fact that your hunger cues aren't convincing you to find a way to eat more often is, yes, an eating disorder.
posted by jitterbug perfume at 3:51 PM on January 17, 2012 [1 favorite]

Please think of this for a moment from your doctors' point of view. You are clearly not "well" in the sense that you are not happy, you come across as frustrated, stressed, near your breaking point, and experiencing some worrying physical symptoms as well. Your doctors are trying to help you as best they know how by matching your symptoms to diagnoses in order to give you medical treatment that will make you better.

It could very well be that this medical treatment is not what you need - that the symptoms you're experiencing are tied to a huge number of stresses...financial and food insecurity, a difficult relationship with your mother, the challenges of navigating the transition from childhood to adulthood. It could be that there are also underlying issues that medical treatment may help. The bottom line is that your doctors are very much most likely trying to help you, they just may not have the right tools at their disposal to succeed.

The thing you need to know is that the situation you're describing is not normal. It's not normal to only eat every other day. It's not normal for doctors not to communicate diagnoses directly to an adult patient. It's not normal, nor a good idea, to be cycling on and off of so many psychoactive substances in such a short period of time. It's not normal to be hospitalized three times but feel that you're not ill. It could be the doctors, it could be your mother, it could be that you are not as ok as you think you are, it could be that your family is in a lot more financial trouble than you realize. But something here is not right, and you need to identify it.

Is there someone you can talk to? A relative? A pastor? A family friend? A school counselor? Any adult who knows you and your family situation, and whom you trust to have your best interests at heart? Please find that person who knows you in real life, and share what you've shared here, and then listen to their advice.
posted by psycheslamp at 4:36 PM on January 17, 2012 [1 favorite]

Has anybody ever experienced these trains of diagnoses that never, ever end?

Everybody with mental health issues has experienced some of that.

I see one reason your diagnosis changed. People who are bipolar have (when they are depressed) the symptoms of depression. Your doctors changed the diagnosis from depression to bipolar when you had a manic episode -- something they hadn't seen before.

Bipolar 1 is not a diagnosis that doctors make unless something very scary has happened. An extreme mood upswing can kill you. Fast. Maybe bipolar is the wrong diagnosis, but whatever's causing it it's not the sort of thing you can beat with willpower. You need to find the right meds.

Yup, being a new meds lab rat sucks and will continue to suck. Wrong meds, wrong doses and suddenly the world feels wrong. Maybe it'll take a year to get it sorted out. That doesn't mean you have bad doctors -- it's just really tough to get it right.

"Lithium made me sleepwalk." If you are currently prescribed lithium and are not taking it, restart now. Whatever your current prescription is, take it as prescribed. Sleepwalking is bad, but it's much less bad than hospitalization or suicide.

"What should I do?" Trust people. In particular, trust your Mom. Tell her your worries about your doctors and let her do the investigating. You're in crisis and you've got enough to deal with right now. Believe her if she tells you to stick with your doctors.
posted by justsomebodythatyouusedtoknow at 5:36 PM on January 17, 2012 [1 favorite]

Unfortunately, there's no way to find out whether a drug like Prozac is going to work for you except by taking it. The most your doctor can do for you while you're trying out a drug like that is to watch you and be available. It's not unusual for an antidepressant to trigger behavior that makes it apparent that medication for bipolar disorder would be more appropriate. In addition, regarding your diagnoses, I know my insurance used to cover only so many sessions unless I had been diagnosed with a condition from the "severe" category (which included major depression, bipolar disorder, and schizophrenia, among others).

Your doctor can only base his diagnoses on what you disclose (although your disclosures can certainly be indirect or inadvertent, though your behavior); if you're tangled up in several different kinds of misery and he's only been seeing you for a year or so, it's not so strange that he might not be able to eliminate certain diagnoses right away, or that new information might shed a different light on known facts. It would be helpful if the person doing all this prescribing got less-infrequent snapshots, though. Would it be remotely possible to go to a psychiatrist who also provides therapy? Can you see a regular therapist (to whom you should provide all the information you've given us) who can advise him?

Finally, I see there are ADD and anxiety meds on that list. Eating a starvation diet, which is what you're doing, is not doing anything good for your concentration or your anxiety. Or your mood, for that matter. If you want a drug to work properly, if you want your meds to match up better to what you actually need, you need to stop making your symptoms worse, so that your doctors can get an accurate picture of what's wrong with you, and so that you can actually suffer less. Even junky 99-cent burgers from McDonalds or a couple of bowls of instant ramen and instant oatmeal, while hardly giving you everything you need or giving you much protection from anemia, would be miles better than nothing at all. But if the state is covering your medical costs, there is also money available to feed you; ask your psychiatrist to direct you to resources. If this is not the case, there is no excuse for your mother to spend money on anything but rent and the heating bill before she buys you enough food to live on. Three meals a day is not a luxury item; it's up there with water.
posted by Adventurer at 9:49 PM on January 17, 2012 [2 favorites]

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