[Rusty9]

There is a quite good article discussing the differences between physical diagnoses and psychiatric diagnoses on this website. A one sentence summary: you have physical diseases, you do psychiatric illnesses. Most people think they have, say a depressive illness. Not so, they did it in front of a psychiatrist or other psychiatric diagnostician. Then he/she put a label on what the patient did, said, looked like during an interview, say anxiety reaction.

In contrast we do have physical illnesses. While some observation is involved the diagnostic process this is backed by lab tests, Xrays etc. which are far more stable than what any of us do, say, act out from moment to moment or hour to hour. I remember studies being done back in the 1950's demonstrating that 2 psychiatric diagnosticians frequently come up with very different diagnoses when seeing the same patient in the same half day. That happens far more seldom with physical diagnoses.

I believe the 2 paragraphs above are true, factual. If I'm wrong I would appreicate being corrected, with explanations, reasons why I'm wrong. Even better would be a reference or two to studies demonstrating I'm wrong. I'll be here a while.

[~Christina]

I'm not sure if you are looking for someone to agree with your comments or disagree..

You remarked about a " good article" Do you want to post the link? So a discussion can start?

Thanks

[onionknight]

A one sentence summary: you have physical diseases, you do psychiatric illnesses

Physical diseases are diagnosed based off blood tests, various types of scans, etc. The criteria are agreed upon and will be diagnosed the same by any doctor based off test results. Psychiatric diseases are diagnosed based off observable behavior or reports of the patients thoughts. The research is yet to find a reliable biomarker for diagnosing any psychiatric illness, quite unlike psychical illnesses. Different psychiatrists might diagnose the same behavior as different disorders. In the sense that you "do" your behavior, this is accurate.

[Rusty9]

Originally Posted by ~Christina

I'm not sure if you are looking for someone to agree with your comments or disagree..

You remarked about a " good article" Do you want to post the link? So a discussion can start?

Thanks

Cristina: I'd be happy with either agreements or disagreements. Do you do either? If so, why?

I'm very new to this site, but the article is somewhere here. I can't refind it. As a veteran poster here, perhaps you can. It was in a series of articles by the same author. In my head, but my memory is poor, his name is Tim Wooton.

[Rusty9]

Originally Posted by onionknight

Physical diseases are diagnosed based off blood tests, various types of scans, etc. The criteria are agreed upon and will be diagnosed the same by any doctor based off test results. Psychiatric diseases are diagnosed based off observable behavior or reports of the patients thoughts. The research is yet to find a reliable biomarker for diagnosing any psychiatric illness, quite unlike psychical illnesses. Different psychiatrists might diagnose the same behavior as different disorders. In the sense that you "do" your behavior, this is accurate.

We agree, Onionknight. Now I'm hoping for some diagreements.

[sabby]

It's easy for 2 different psychiatrists to come up with different disorders regarding the same person off the same tests as there are so many different behaviors that overlap within different disorders.

As a lay person, I'm more inclined to believing that treating the behavior(s) is much more important than the diagnosis itself. I also believe that people don't/shouldn't have to be defined by their diagnosis.

[Rusty9]

Originally Posted by sabby

It's easy for 2 different psychiatrists to come up with different disorders regarding the same person off the same tests as there are so many different behaviors that overlap within different disorders.

As a lay person, I'm more inclined to believing that treating the behavior(s) is much more important than the diagnosis itself. I also believe that people don't/shouldn't have to be defined by their diagnosis.

Another agreement. Thanks. And no disagreements. Those who treat diagnoses are too busy making money by simply handing out prescriptions---10 or 15 minute appointments. Does anyone know how long psychiatric appointments have to be before BlueCross/Shield and other insurance will pay? Do they pay in equal increments if someone does hour long psychotherapy appointments. Do they encourage of discourage psychotherapy? My memory is they discourage it.

[avlady]

Sounds interesting to me, I do agree.

[~Christina]

Personally for you , Yes tomental illness is almost unproved, Just assumed, But there are testing to prove the mental illness.

I have a Chronic pain condition that can not be proved yet,, it is present.

This question has been asked many times .

I suppose it is just a personal decision .

[onionknight]

Do they pay in equal increments if someone does hour long psychotherapy appointments. Do they encourage of discourage psychotherapy? My memory is they discourage it

.

You'd have to check with your individual insurance plan. Some only pay if you go to therapists in their network. Generally, the talk therapy coverage is less than "medical" coverage. Biomedical models have saturated mental health care so it is much more difficult to get coverage or information in regards to "alternative" treatments than psychiatrists. Also, don't forget most psychiatric medicines are prescribed by non-psychiatrists so that says something about where people are getting their treatment.

Just to be clear. Just because there are no clear, definitive biomarkers that are the same across all patients, don't mean the symptoms aren't real. Treating the symptoms and prompting a fulfilling life should be most important.

[Perna]

I think they are more alike than dislike in many instances. I "do" throwing up too and it is partly by that that I am diagnosed as having the flu. When I stop throwing up, I don't have it anymore. I "do" not being interested in life/getting out of bed/bathing and it is partly by that that I am diagnosed as having depression. When I get up and get going under my own will/steam, I don't have it anymore.

There are always physical attributes to mental illnesses and mental attributes to physical ones; people with heart problems often have depression and vice versa, for example: NIMH - Depression and Heart Disease

The body is "whole", we just divide up "types" of illnesses as a help in knowing how best to approach and treat them.

[Rusty9]

Originally Posted by onionknight

.

You'd have to check with your individual insurance plan. Some only pay if you go to therapists in their network. Generally, the talk therapy coverage is less than "medical" coverage. Biomedical models have saturated mental health care so it is much more difficult to get coverage or information in regards to "alternative" treatments than psychiatrists. Also, don't forget most psychiatric medicines are prescribed by non-psychiatrists so that says something about where people are getting their treatment.

Just to be clear. Just because there are no clear, definitive biomarkers that are the same across all patients, don't mean the symptoms aren't real. Treating the symptoms and prompting a fulfilling life should be most important.

Yes, GP's do a lot of that, trying to satisfy patient requests for drugs, to not spend a lot of time with patients, and incidentally make some money.

[healingme4me]

Originally Posted by Rusty9

I'm very new to this site, but the article is somewhere here. I can't refind it.

Are you thinking about the neuroimaging studies? There was a recent PC Blog, I'm sharing the link to that. Just in case, that's what you have in mind??

Neuroimaging: A Primer | Psych Central Professional#

[onionknight]

I think they are more alike than dislike in many instances. I "do" throwing up too and it is partly by that that I am diagnosed as having the flu. When I stop throwing up, I don't have it anymore. I "do" not being interested in life/getting out of bed/bathing and it is partly by that that I am diagnosed as having depression. When I get up and get going under my own will/steam, I don't have it anymore.

This is a faulty comparison because we can tell exactly who has the flu because we know how to identify strains of the flu virus. Yes, on an everyday basis your doctor might diagnosis the flu off symptoms, but researchers have identified the flu viruses that cause the flu in everyone. Researchers are yet to find that biomarker for mental illnesses.

[Rusty9]

Originally Posted by healingme4me

Are you thinking about the neuroimaging studies? There was a recent PC Blog, I'm sharing the link to that. Just in case, that's what you have in mind??

Neuroimaging: A Primer | Psych Central Professional#

Thanks, but that's not it.

[Perna]

Onionknight, biomarkers are increasingly being used in psychiatric medicine also. I was commenting that the have/do way to tell the difference between psychiatric and physical disease was too inexact. Psychiatric illness is a physical illness; we are not "head" and "the rest of the body".

http://www.upstate.edu/psych/researc..._Interview.pdf

[Rusty9]

Originally Posted by Perna

Onionknight, biomarkers are increasingly being used in psychiatric medicine also. I was commenting that the have/do way to tell the difference between psychiatric and physical disease was too inexact. Psychiatric illness is a physical illness; we are not "head" and "the rest of the body".

http://www.upstate.edu/psych/researc..._Interview.pdf

i
Read it. They are not used in psychiatric medicine. The article says research has far far to go before that is possible.

[onionknight]

There are individual doctors who may use brain scans or blood tests in their treatment or prevent, and researchers who have seen brain changes with mental disorders, yes, but we use observable behavior and not these tests now (which is frequently the opposite with illnesses elsewhere) to diagnosis mental illness.

[newtus]

i dont understand the "you do your psych illness"?

[Rusty9]

You do it like you do everything in your life, newfus. What a psychi illness is, is how a patient talks, acts, looks. It is not something he "has." Do you do a psych illness? Another way to ask the same question is, "Did you act in front of a psychiatric professional in a way that led him/her to tell you you have a psychiatric illness?" Does that clarify it for you?

[Rusty9]

6/3/13---6:50am---Monday: I noticed I forgot my evening pills last night as soon as I sat down in my lounger. I'm forgetful, but at 31,575 days old I'm entitled. Also entitled to my clumsiness that just knocked a box of pills off the table beside me. And I have earned the affection of my 13.5 lb Jack Russell terrier/chihuahua cross who just jumped up beside my lower legs and is peeking around my computer screen. Lots of things I've earned. But, I'll stop now and concentrate on enjoying my first coffee of the day. I'll also concentrate on counting every breath for a while. 1, 2, 3,..

[Rusty9]

305 at7:44am, and I counted every breath while I was gone for 54 minutes. Not counting as I write, but I am staying aware of breathing deeply and fully as I write. Taking deep full breaths is something I enjoy, and it also is good for me. I think it is good for anyone, but I know that most people pay no attention to how they breathe. I believe they just go on with whatever breathing habits they established before they had whatever good sense they currently have.

Many of my habits from back then are bad ones, and I enjoy trying to change some that I discover as I go along. I also try to keep aware of anything I do that helps me enjoy life, including noticing and stopping myself from continuing with a few of my bad habits. Staying aware of every breath I can, helps me notice and work on changing some of my bad habits. Time to stop, Rusty. You're getting to damn serious. That's one of my bad habits in writing. It's 8:04am. 306.307,308..

[Rusty9]

600 at 8:40am. And I'm going to stop counting breaths for a while. Just try to keep aware of all of them without verbally reminding myself to pay attention to each one by counting. Time for breakfast soon, and I'll be talking some with the 4 other people in the house I did miss counting a few breaths between 306 and 600 while talking with Potter, my daughter Siri's husband. But I did hold in mind the last one I counted and resumed with the next number. It's 8:44.

165 plus 600 makes 765 breaths counted and it's 10:00am: Finished breakfast, bacon, scrambled eggs, 1 toast, jam and a glass of what tasted like grape juice and I just finished my 4th cup of liquid, coffee. Tried to stay aware of breaths thru breakfast, talking "spontaneously" with mainly Tiana's guest, Brendan. Breakfast tasted very good and I came close to being aware of every bite, how it tasted, how it was different than the previous bite, etc. "Spontaneously" is in quotes because it also means impulsively, without thinking, without delays. Please note, some of the meanings are negative, some positive. Also note that I chose one that is currently, I think, regarded as positive---spontaneously. Word choice, what I tell myself is one way I make myself happy. 10:09am. 767, 768, 769...

[Rusty9]

1100 at 11:06am: I'm on my 5th cup, ice tea. Had an easy 4 push BM. I try to keep track of liquid intake, bowel output, bran intake, trying to keep myself healthy. I'm going downhill, having a failing heart that pushes out an abnormally low amount of blood. Breathing fully and deeply makes up for that a bit.

I went out to watch Tiana and her guest Brendan splashing in the $20,000 plastic, above ground swimming pool Potter finished installing while he was here for 5 days. He left shortly ago for his next 2 weeks on his job in Texas. I walked once around the pool, giving it a wide berth to avoid splashes, and sat down far enough away. Tiana is 13, and I enjoy watching her, watching her develop, learn and grow. 1101, 1102, 1103

12:17pm: Have been counting breaths only erratically since my last post. Have been aware of many more than I counted. But, one reason I am posting here is I know about psychiatric illness from both sides of the desk. I was retired from the Veterans Administration as a clinical psychologist on July 18, 1980. I treated a lot of veterans.

I was hospitalized for "schizophrenia" for about 7 days in 1971. I was hospitalized again for about the same length of time in 1980. During this one, I discussed my diagnosis with my psychiatrist, but have forgotten what we agreed on. Neither he nor I took the idea of diagnoses being very useful in treatment seriously. I am hoping that discussing my experiences on both sides of the fence here might be helpful to both patients and other professionals who post here.

I am not very optimistic it will be. My experience with both psychiatric professionals and patients is that they both have big problems with listening and using what they hear. Patients are much worse at it, of course, but professionals have their difficulties in hearing as well. I feel sure many patients know that very well. Feel free to say so here, any readers that are patients.

[Rusty9]

2:17pm: 400+1100=1500. And I've stopped counting to eat bran and perhaps talk with Siri or the girls. They both enjoyed a movie Siri took them to title EPIC. Now, bran flakes...185+1500=1685 at 3:30pm: A lot going on at the moment: TV on, loud enough to hear but of course not understand because of my hearing problem. Tiana and Brendan are playing with Tiana's many nail polishes etc. Siri and the two girls are talking off and on. And I am enjoying it.

I didn't when I first moved in with Siri 5 months ago. I was too accustomed to silence. I'd had lots of it and enjoyed it for more than 3 years before that. It was up to me to adjust to and learn to enjoy the way Siri's household works. That's what all old folks should do when they move in with their children. I'm sure many don't. Instead they depress themselves about what goes on in their kid's house. Or perhaps they try to change the way the household works. Both a hopeless task and a good way to get the children resentful and regretting they took the parent in.

It took me about a month of working on myself to stop irritating myself with all the noise---even reach the point where I can enjoy it, as I am doing now as I am typing. My attention is a bit split, but I believe I am writing coherently and understandably. Please tell me if I am not.

I made use of my breathing awareness to change myself. Every time I caught myself being irritated, I tried to look at what I was telling myself, how I was talking myself into feeling irritated. When I found that, I deliberately changed what I was telling myself. An example is, "Why don't you enjoy Tiana's enjoyment of the TV, Rusty. That's much better than irritating yourself." It took a little over a month for me to stop irritating myself and start to enjoy the reality of Siri's house. During that month, at times I chose to go to my room and shut the door, effectively blotting out the noise. It's a long while since I did that.