[Berries]

I really want to know what my diagnosis is—not what it was or what previous pdocs have said it was. What it is NOW, currently. I have a new pdoc. I’ve been seeing him for 3 months. I told me early on that “we’d figure out my diagnosis.” But, so far, he’s just gone on what I told him previous pdocs have said.
I have an appointment with him next week. It’s only a half hour appointment. I know he is planning on talking about medication changes, and these are changes I don’t want to make. But I don’t want to spend he half hour arguing with him about it, like that last appointment I had with him, 5 weeks ago.
I want to ask him to diagnose me! Himself! I was diagnosed at age 17 as schizoaffective and have had that lable follow me for 25 years, with every succession of pdoc’s just blindly following the last. I really don’t think I am SA. I may be bipolar. I may be something else. I may be “normal”.
I want an original, thoughtful, professional opinion based on the way I am NOW!
I won’t see him again for at least 5 more weeks, maybe even 8 to 12 more weeks. This is driving me nuts! (no pun intended). I need to know what he thinks. Maybe it will help me stop obsessing about this issue. Maybe it will reassure me and I won’t be so anxious anymore. Maybe it will help me stop being suicidal.
Does anyone have any ideas on how I can get him to diagnose me? How I can keep on point during the appointment so it’s not wasted?
And more than anything, Is it OK for me to ask this. I go to a low-income mental clinic and he has LOTS of patients and not a lot of time to devote to each one. Is it still OK for me to ask him to do a little extra work—giving me tests, or just interviewing me again? I don’t have a choice as to my pdoc. This is the only clinic I can go to.

[MSUKate]

The odds are that if you are doing fine, and you ask for a new DX he will probably say SA in remission. DX'es seem to stick around even if they aren't 100% correct.

Personally I do not care what the DX is, so long as I'm getting help to feel better. I see it akin to a dress size. I might "know" that im a size 8, but I just happen to put on a 10 and it works fine. The number, the DX isn't what is important. ITs only important to those who want to classify things or for insurance purposes, which is essentially the same thing.

I try to remember something that a doc said to me once about DX'es are really broad strokes, but everyone's personal disease presents slightly differently.

If you really want a new DX, I would ask, say something akin to "I haven't had symptoms X, Y, Z in years, if I ever had them at all, do you think the SA DX is appropriate for me?"

I feel that if you pose it as a question the doc still feels "in charge" (dont they love that) but you still get the information that you need.

If you really feel like he isn't treating you correctly you always have the option to find someone else. Just go in blind and say "yes I have a psych history, but i want to get your opinion without hearing what others have said, becauase I think things may have changed...." or something to that effect.

I know I might not help much, but that's my two cents on the matter.

Take Care

-Kate

[madisgram]

hi lb, i tend to agree with kate's post...if you feel you are doing well with your meds i'd not worry too much about the dx for now. when your situation changes and you can choose the pdoc you see that might be the opportune moment to discuss this.
on the other hand, if you are doing well and don't feel that a med change is needed i'd tell the pdoc (you are seeing now) just that. ask him why he prefers to change your meds. a little discourse is helpful. like you said, don't let this use up the limited time you have unless you just can't be comfortable with his suggestions. if that is the case i'd request another appt. sooner than 5 wks. to discuss this in more depth. it's worth a shot if you are not happy with the results of this next visit. it's challenging at best to find good pdocs and this limitation of scheduled time does limit your recourses for now.
perhaps a good thing to do is write some of your primary concerns on a piece of paper before seeing him. this might remind you of the most important segments you feel you absolutely must discuss this upcoming visit.
another thought: he may just surprise you with news you want to hear.
i hope this helps. let us know how it turns out, k? we care about you.

[Berries]

Actually, I am not doing all that well. Part of it is doubting I’m ill.
In theory, I agree with both of you, DXs are really meant for pdocs & Ts to communicate with ea. other and insurance companies. And that everyone presents differently, even within the same disorder.
But at the moment, I really need to figure out if I actually had & have a severe, chronic, debilitating mental illness. It’s a long and complicated story, but basically it involves my suicide if I don’t have a S,C,D mental disorder. Part of it is exactly what DX I have.
I need to know. I have to know. And hopefully, the answer will reassure me and help me get to a better place, so I can stay alive and move ahead with my life.
Thank you, Kate & Madisgram. You did help!! You are right, I’ll pose it in a way that makes him feel “in charge”. And I will bring in my journal with a page devoted to my concern and why. It also has lists of symptoms in it that I could show him if he asks. Maybe, I could just ask if we talk about my concern first and then discuss the med change he wants to talk about? That’s fair, right? He works for me, right?
I wish like hell, I’d never told him what other pdocs have said, because he is my only option—nobody else in this town I moved to takes Medicare/Medicaid!!!
Thanks Gals!

[Michah]

Oh my goodness! I agree with all of you but I m having a hard time comprehending the extra suffering you have to go through with your health system. I am in Australia and our public health system is shocking but without it, I may not be here and I have used it for many years as I was dx schizoeffective and bpd 16 years ago and had many hospital admissions. I see a private psychiatrist now and he is not cheap but we get some money back from medicare. He took six months to officially diagnose me with BP type 2. I was on lithium and antipsychotics the whole time mind you as I was a little out of control and had had a 3 week psych hospital admiss. last year in the public hospital system before I had started to see him. I was not happy with the diagnosis of the hospital.(In their infinite wisdom, they said I was suffering "burnout"!). But the meds are working.

Yes, your shrink is working for you. Maybe you could kindly point out that you not only need a diagnosis to better understand your state but that he/she is supposed to be healer and therapist as well. He is not a general practitioner! I have debates with my shrink all the time but he is good at debating the logic and the science which is what I understand the best and if his argument is more logical than mine, I am more likely to go with what he says. But I am not an easy patient, even if he says that our sessions are challenging but entertaining! The important thing is that he asks me what I think about my treatment but is firm when I am irrational or obsessive. Teach your shrink how to treat you. I only wish I had been this empowered years ago.

Don't know if I have helped or made things worse but I would like to see you achieve some peace so you can move on to the healing. Good luck!