Chicken or the Egg

I know this is a very complicated issue and I don't expect that lots of people can give me definitive answers. Mostly I am looking for input on what individuals have experienced with this. I am going to try SO HARD to keep this as brief as possible!

I have noticed that so many of us here have a variety of diagnoses. It also appears that lots of people take a combination of meds. Maybe some of you take meds for one thing, but have chosen not to take meds for another. And I do know that some meds can address a variety of things. And I also know that so many issues cannot be separated and overlap and all of that.

I guess I am wondering a couple of things:

-Do you see one of your issues as being "The biggest" one, and if so , do you concentrate on that one the most- using meds for it?
-After all of these years, are you still wondering if you have received the correct diagnosis? Does it ever seem to change for you?
-Is there a certain issue that you absolutely must tackle first in order to make progress with the others?
-Is there a distinct difference between the issues or do they all overlap.
-Do you ever sort of ignore one thing and it is just fine left alone?

For example, if you have ADD, and you don't regularly take meds for it, does your lack of focus prevent you from doing better with other things? Or say you take meds for it, but they have side effects that you think might interfere with other issues.

I mean, it is all so freakin complicated that when I try to figure out what is the right thing to do, I get overwhelmed. I am trying to self educate and advocate for myself but I really don't even know which of my issues should be addressed with the most action/meds. I am guessing depression, yet it is because of so many reasons that I am depressed- not a situational type thing.

Right now i am trying to reevaluate and make some changes cuz things are just not working out. I seriously do not know whether to increase or decrease certain meds, or stop them all together or try something else. I just feel so flat and bored and uninterested and fed up and discouraged and always I have felt "Is this as good as I can expect to ever get?" Because it is not enough, even though I know it could be worse.

Yes, I know about trial and error, and combinations etc... But then there is the whole "Does that _____ make the ______ worse?

And lastly, on the same note, don't many of you have trouble knowing which section you should post under on this site??

Hello, hayward. Each of us is different. The symptoms you present likely differ from others, as least in some respects. What we did may not be right for you. Treatment plans are individualized for that reason.

You might consider printing your post for your psychologist. She/he will be able to help you with your concerns.

Good luck.

G'day, Hayward!
Outstanding advice. Posting has many uses, and that is a good one.

Do you see one of your issues as being "The biggest" one, and if so , do you concentrate on that one the most- using meds for it?

• Depression is my #1. My other problems could eventually kill me; depression (together with its auxiliaries) could lead to self-harm. I take a number of meds for different conditions.

After all of these years, are you still wondering if you have received the correct diagnosis? Does it ever seem to change for you?

• I am confident of the depression diagnosis and a few others. I now have a Generalized Anxiety Disorder diagnosis that grew out of an inability on the part of the medical folks to satisfactorily pin down a neurological issue -- and there is a neurological issue. Some gray area exists between psychiatry and neurology.

Is there a certain issue that you absolutely must tackle first in order to make progress with the others?

• In my case, it's unclear the medicos and their bureaucracies (plural) believe I can make progress. I feel I've been "triaged" off to the side. (I'm a bad one to attempt to answer this question.)

Is there a distinct difference between the issues or do they all overlap.

• They are all intertwined. Worse, with all the meds, I cannot isolate the effects of any specific one, and some of the side effects of the meds are identical to the primary effects of some of the illnesses.

Do you ever sort of ignore one thing and it is just fine left alone?

• No. They all cry out for attention all the time. Yes, I do get to feeling overwhelmed. And when I'm overwhelmed, I return to your first question -- depression comes first, and I attempt to meet its "needs" before the others.

...don't many of you have trouble knowing which section you should post under on this site??

• I'm generally too apathetic to worry about it. I make my best guess and then trust the moderators/administrators to move the subject as they see fit.

Wishing you a hopeful New Year, Hayward!

Hi Hayward ~ My biggest issue is pain. I have to concentrate on that first because I can't walk if I don't.

I wonder alot if I have the correct diagnosis(s). It just seems that I have too much pain for DDD and osteoarthritis. Just doesn't make sense to me.

Yes, I have to tackle the pain first before I can address the other issues.

Yes, there is some difference between the pain and other issues.

No, I'm not leaving the others alone because it's NOT fine.

I usually post between Chronic Pain and Spinal Disorders.

Generally, this site in an excellent one. God bless. Hugs, Lee

Oh this is frustrating. I typed a lengthy reply to you only to lose it as I went to post it.

Am going to try again....

Hayward, you'll probably find this frustrating yourself, but as I said to you in another thread YOU are the only person who can decide what's right for you. Having said that, I remember there was a time that I desperately wanted someone else to tell me what to do. I "just" wanted someone to give me the answers so I would feel better. Blessedly I had a therapist and pdoc who helped me find the answers that were right for me. Do you have a therapist and/or pdoc? If so have you talked to them about what you've posted here? That might be a helpful place to start.

Not sure if my answers will be of any help to you, but here goes...

-Do you see one of your issues as being "The biggest" one, and if so , do you concentrate on that one the most- using meds for it?

My primary diagnosis is major depression but I've also dealt with "symptoms of PTSD", self-injury, DID and OCD and other anxiety related tendencies. I take anti-depressants because until I gained some control over the depression I was incapable of dealing with any of the other problems. As an added benefit one of the anti-deprssants I take helps with the self-injury and OCD-like "stuff".

-After all of these years, are you still wondering if you have received the correct diagnosis? Does it ever seem to change for you?

I'm confident that the diagnosis of major depression is spot on.

-Is there a certain issue that you absolutely must tackle first in order to make progress with the others?

I'm not sure what you mean by "issue". If you mean diagnosis, then like I said above I had to get a handle on the depression before I could make any progress on the other psych problems.

If by "issue" you mean life events related to my diagnosis I had an abusive childhood followed by 26 years of an abusive marriage, a history of childhood sexual abuse, sexual assault in adulthood, an auto accident that nearly killed me and the death of my older brother and protector when I was 15. While I dealt with these things in therapy, I needed the anti-depressants to gain control of my depression before I could really work on the "stuff."

-Is there a distinct difference between the issues or do they all overlap.

It's all tangled up.

-Do you ever sort of ignore one thing and it is just fine left alone?

Not sure if this is what you mean, but I never actively worked towards integration of my alters. As I worked through things in therapy they each seemed to be willing to join in with the rest of us. Not sure that's "ignoring" the problem. I spent time talking to my innder system before they joined in, but I didn't out and out try to get anyone to join in.

While depression is the only thing I take meds for I've addressed the rest of my "stuff" in therapy so I guess I didn't "ignore" it.

And lastly, on the same note, don't many of you have trouble knowing which section you should post under on this site??

Oh heck yes!

your thread posts some interesting questions for all of us. what i found that works best for me is a comination of CBT, proper diagnosis, and meds. i have found however if i don't see a "good" psychologist, PHD in my case, and a "good' psychiatrist whom i call a good chemist, my results can be below the norm for positive results. i often wonder if those who suffer so extremely here at pc have been less fortunate than i. my therapy has immensely helped me learn to cope with life which of course lessens the intensity of my bipolar disorder in my case cause i am functioning with most "of the oars in the water". i know i must direct and "own" my therapy. it is not my therapist's job. what i put in is what i put out. no pain, no gain in my case. when i hit a major snag i schedule to see my T to gain input and understanding of what i can't figure out by myself. if i do this quickly enough many times i can avoid the deep depression i have sometimes or my pdoc to tweak my meds. i know for a fact that i benefit from meds...my life was a constant struggle before them. today i can most times function well taking them. but if i only had meds and no therapy i don't believe i would have good results. for me they go hand in hand.
but i do not know if i am the exception based on the ppl here who suffer in spite of getting help. that troubles me and causes me to question why they don't improve as i did. part of the reason i believe is we are all different. part of the reason is misdiagnosis resulting in the wrong meds for that individual.
idk, just thought i'd put this out there.

A thyroid condition and menopause were the triggers for my latest fall from grace into the arms of magnified bi polar symptoms. Treatment to stablize my thyroid was my initial focus. It provided modest relief to depression. I avoided hormone replacement therapy and meds for the bi polar symptoms for years after my initial thyroid diagnosis.

I wondered that all the time until I had collected so many labels that it all seemed pointless to me. I also discovered so many overlapping symptoms between diagnosis that again considering them seperately became pointless. At the end of the day I figure what really matters for me is to focus on the symptoms. Symptoms are more specific to me and areas I need to manage. I was slow to step into the land of meds and have been very specific about what symptoms I wanted treated. Sleep is problematic for me along with hyperspeed thinking. I take an anti-psycotic med that slows down my brain activity so that I can sleep through the night. Mood swings are problematic so I take a mood stabilizer to lessen the extremes. Anxiety and hypersensitivity to stimulation are problematic so I have learned a lot of techniques for coping.

Stabilizing my thyroid was my first order of business. Then it was getting quality sleep. The lack of sleep was a trigger for everything else so it had to be dealt with before I looked any deeper. Once I started sleeping properly I was in better shape to make progress in other areas.

They all overlap. That is why I deal with symptoms rather then specific diagnoises. The labels are a guide, the symptoms are sign posts.

Sometimes I think I probably do. I will ignore my issues with anxiety and venture into things I would otherwise avoid to insulate myself from an attack. Sometimes it works out and sometimes it doesn't.

I think the med journey is a difficult one at the best of times. The questions you are asking might best be discussed with your doctor or even a pharmacist. I know what you mean about how overwhelming questions around med treatment can be. It doesn't take much to overwhelm me with all the variables one needs to consider. Honour your questions by taking them to the pros and see if they can't help to put you ahead of the game instead of feeling discouraged and dissatisfied with your current situation.

You are to be commended for your determination. Above all else that strength of character will lead you to the resolutions you seek.

Wishing you only wellness

When things get too complicated, mixed-up or murky for me, I decide to start over, which I think of as "throwing a hand grenade into my own foxhole".

Stop thinking of it as you have been thinking of it; give up on the chicken and egg insolvable problem and grab some little piece that does make sense to you and start there. Were I you, I would start here:
Grab one of those and think of one thing you would like, anything. I started once with wanting an ice cream cone and spent the rest of the day getting myself that

Feelings and actions happen together but our wills can do something about actions whereas they don't have any purview over feelings. That's why when you smile, whether it's fake or not, you feel better, the whole "fake it until you feel it" thing. Studies have shown that people who use botox don't feel as angry as often (presumably because they can't move the muscles of their face to look/"act" angry).

So, grab a negative feeling you feel, a specific one, and do something that shows the opposite feeling. For "flat" I would make something funny happen ("flat" makes me think of ironing and ironing when I was feeling flat would seem really ridiculous to me and make me laugh I think). For fed up and discouraged, I would do chores that need doing (clean up something) or help someone else (helping someone else would be encouraging to me, would mean I could be make a difference so maybe I could make a difference in my own life too).

I know it can be very frustrating if things are not clear, if we don't "understand" and really want to. In the beginning of my therapy my T would often have to "stop" what we were discussing and explain that there was no point in our discussing it right then because it wasn't possible for me to understand it right then. As frustrating as that was to me, I really really had to know and know now, over time I began to notice that it was like sleeping on a problem; in a day or week or so, something else would happen in my life that would explain to me what it was I hadn't understood, I'd be walking down the street and suddenly think (and sometimes say, talking to myself :-) "Oh! Is that what it is!" If I could do it all again, I would quit fighting so hard to understand and start looking forward, instead, to myself/unconscious figuring it out as I worked through other things in the near future.