[monkeybrains21]

I want to ask my T for a diagnosis without actually asking it. I know it doesn't change who I am but it will change how I manage things. I need to know so I can read up on it and focus on getting past it all. Pdoc diagnosed anxiety and depression however there have been many talks of PTSD and BPD without actually dx me. Any advice?

[ilikecats]

I know you said you want to ask without actually asking it, but I think actually asking it is the only way to do it. Just let your T know you want to know your diagnoses, and maybe let her know why, like you did here.

[retro_chic]

Yeah, I think you should just ask . I asked my ex T once if she thought I had BPD and she brought out her DSM and went through all of the symptoms with me and after discussing it we came to the conclusion that although I have some BPD traits I don't meet the full diagnostic criteria. Maybe it is the same for you and that's why "there have been talks about it" but no actual diagnoses? It's always worth asking I think!

[spring2014]

Originally Posted by monkeybrains21

I want to ask my T for a diagnosis without actually asking it. I know it doesn't change who I am but it will change how I manage things. I need to know so I can read up on it and focus on getting past it all. Pdoc diagnosed anxiety and depression however there have been many talks of PTSD and BPD without actually dx me. Any advice?

hi monkeybrains,
my therapist told me from the intake assessment that I diagnosed with anxiety and depression . she did a psychological evaluation on me on the fourth session just to make sure her diagnosis was right and I was also diagnosed with ptsd . I would ask your therapist to do a psychological evaluation on you to just to make sure that his or her diagnosis is right .




Diagnosis: Anxiety and depression
meds : Cymbalta 60 mgs at night
Vistrail 2 25 mgs at night for insomnia with an additional 25 mgs=75 mgs when up past 1:00 in the morning

[ScarletPimpernel]

I asked my Pdoc and T to diagnose me. They did.

[BudFox]

I'm curious why people would want to be saddled with a diagnosis. I assume it is the desire for some sort of certainty, which I understand, but seems like such a dangerous game.

I am the opposite -- I actively resist such things. If a professional said I had "XYZ Disorder" I would ask them what objective basis is there for this. If they pointed to the DSM, I would say these are arbitrary labels, mere descriptions of symptoms and behavior, decided on by panels of industry appointed experts. If a diagnosis is to be useful, I think it has to identify cause.

Even a diagnosis of "depression" or "anxiety" is to me completely meaningless. These are symptoms not disorders or diseases. Is it anxiety from trauma or from magnesium deficiency?

I would think a person has a right to know when a diagnosis has been applied to them for a variety of reasons. One, in the case they feel it might be incorrect so they can work to get the correct treatment. Two, in some cases effective treatment, both therapy and meds, can be somewhat dependent on that diagnosis and I prefer to know the rationale for my treatment (which is generally based on diagnosis). Three, a correct diagnosis can help a person gain a better understanding of what is going on with them, give them an opportunity to educate themselves about specific issues they are seeing in themselves.

Not everyone wants to know their diagnosis, and some feel "saddled" with a diagnosis. That's very true. Others of us find knowing the diagnosis actually rather liberating because we can finally understand what the heck we have been experiencing and see that we are not completely alone in these struggles. We can research best practices for treatment and advocate for the right approach for ourselves rather than blindly following what the doctors or therapists are doing because we really don't know what they are treating. I'd rather be an educated consumer of my care.

[BudFox]

Originally Posted by lolagrace

I would think a person has a right to know when a diagnosis has been applied to them for a variety of reasons. One, in the case they feel it might be incorrect so they can work to get the correct treatment. Two, in some cases effective treatment, both therapy and meds, can be somewhat dependent on that diagnosis and I prefer to know the rationale for my treatment (which is generally based on diagnosis).

I assumed the OP was requesting that a diagnosis be made, as opposed to wanting to know the details of of an existing diagnosis that has been document somewhere. So I was commenting on the former. But yea I can see wanting to know what diagnosis has been applied.

Re: treatment, how can you treat something without identifying the cause? For example if you are diagnosed with "OCD" what does that mean? Is the brain sick from environmental toxins or a chronic bacterial/viral infection or leaky gut/leaky brain? Those are diagnoses. When a mental health professional assigns "OCD" and classifies it "psychiatric disorder" they have effectively accomplished nothing and potentially set in motion a dangerous course of "treatment".

Originally Posted by BudFox

Re: treatment, how can you treat something without identifying the cause? For example if you are diagnosed with "OCD" what does that mean? Is the brain sick from environmental toxins or a chronic bacterial/viral infection or leaky gut/leaky brain? Those are diagnoses. When a mental health professional assigns "OCD" and classifies it "psychiatric disorder" they have effectively accomplished nothing and potentially set in motion a dangerous course of "treatment".

A person can display symptoms and not really know what set them off, even with a medical illness. This isn't a problem just with psychiatric issues. Do we wait to figure out what caused the symptoms before we try to relieve them? Or, do we make a diagnosis based on the symptoms, begin hopefully the right treatment, and work concurrently in trying to find a cause if it is even possible. Sometimes the cause is never really identifiable by the way, but treatment can still be effective.

[ruh roh]

Originally Posted by monkeybrains21

I want to ask my T for a diagnosis without actually asking it. I know it doesn't change who I am but it will change how I manage things. I need to know so I can read up on it and focus on getting past it all. Pdoc diagnosed anxiety and depression however there have been many talks of PTSD and BPD without actually dx me. Any advice?

Maybe one way is to say, "So what do you think is causing _____(symptom/s)?"

I agree with Bud that a lot of diagnoses are made that are really symptoms associated with a host of possible causes. Often, biological reasons are overlooked as the causes of depression, anxiety and mood instability (toxins, deficiencies, poor digestion); and trauma symptoms can be mis-diagnosed as a personality disorder.

I feel fortunate to have a therapist who considers all influences. Even though she's not a physician, she encourages exploring physiological causes in addition to the ones that she can help with through therapy.

She won't give a diagnosis, even when I have asked. But, when I ask what she thinks is going on (as in, what's causing this?), it's been more productive for me.

[Catlady360]

I'm not 100% therapists can diagnose patients. Psychiatrists can, but a therapist? I think they can suggest that you go to a psychiatrist to get it checked out.

In any case, a good psychiatrist (like mine for example) will rule out thyroid issues and such.

I do agree that you should ask something along the lines of "So what do you think is causing "X" (symptoms)?"

Good luck with everything OP.

[LonesomeTonight]

You could say something like, "So my p-doc thinks I have anxiety and depression, but I've read a bit about PTSD and BPD and am wondering if those might fit, too?"

I asked my T once if I could possibly have bipolar II, and we had a good discussion about why she didn't think that I did ("official" diagnoses are generalized anxiety disorder, panic disorder, OCD, and some major depressive episodes). Talking to her about it was helpful though, because it brought up a couple symptoms that I hadn't really mentioned before because I didn't think they were important (they were things I read in a bipolar II checklist).

Originally Posted by Catlady360

I'm not 100% therapists can diagnose patients. Psychiatrists can, but a therapist? I think they can suggest that you go to a psychiatrist to get it checked out.

In any case, a good psychiatrist (like mine for example) will rule out thyroid issues and such.

I do agree that you should ask something along the lines of "So what do you think is causing "X" (symptoms)?"

Good luck with everything OP.

Therapists can make diagnoses. In fact, PhDs are generally the ones who do psychological testing. I think the OP already has diagnoses from his pdoc and is simply wanting to discuss with his therapist if the therapist concurs with those diagnoses or if the therapist sees anything else at play.

I do agree that a good pdoc will check out physical issues. That has always been my experience -- lots of medical evaluation to rule out issues of thyroid, nutritional deficiency, blood disorders, etc.

[eeyorestail]

Originally Posted by BudFox

I assumed the OP was requesting that a diagnosis be made, as opposed to wanting to know the details of of an existing diagnosis that has been document somewhere".

If OP is in the U.S. and if the therapy is being covered by insurance, there is a diagnosis on file.

Sent from my iPhone using Tapatalk

[ruh roh]

"I think the OP already has diagnoses from his pdoc."

The OP is a she, not a he.

[luvnola]

I'd ask. It's not a secret and your t would be happy to give you information about you, I'm sure. And also, if you think the other dxs make sense, then go ahead and read up on them, and learn about what you can do to help yourself. Also, bring it up to t. I've had many conversations with ts about my dx and none have minded, even when I've told them I thought they were wrong. It leads to good discussions.

[monkeybrains21]

Originally Posted by luvnola

I'd ask. It's not a secret and your t would be happy to give you information about you, I'm sure. And also, if you think the other dxs make sense, then go ahead and read up on them, and learn about what you can do to help yourself. Also, bring it up to t. I've had many conversations with ts about my dx and none have minded, even when I've told them I thought they were wrong. It leads to good discussions.

That's just it, I haven't a clue how to ask. I don't know how to ask for anything. I don't know how to define feelings or even recognize what I feel. All I know is extreme rage.

T has me doing a mood tracker and it's one of the hardest things ever just to put a name to what I'm feeling and then figuring how extreme. My wife jokes and says she'll write my moods and give it to my T but I can't read it. I was thrilled when she said that I was like please do! Then she said she wasn't serious and that was just a let down. I can't recognize my mood changes or anything but she can and I thought that might help but she isn't going to.

[Mygrandjourney]

Originally Posted by monkeybrains21

That's just it, I haven't a clue how to ask. I don't know how to ask for anything. I don't know how to define feelings or even recognize what I feel. All I know is extreme rage.

T has me doing a mood tracker and it's one of the hardest things ever just to put a name to what I'm feeling and then figuring how extreme. My wife jokes and says she'll write my moods and give it to my T but I can't read it. I was thrilled when she said that I was like please do! Then she said she wasn't serious and that was just a let down. I can't recognize my mood changes or anything but she can and I thought that might help but she isn't going to.

Will she at least give you her opinion?

[monkeybrains21]

Originally Posted by Mygrandjourney

Will she at least give you her opinion?

My wife? I'm unsure. I've asked in the past and she's refused because she thinks it upsets me too much. Of course I get upset. It tells me how insufficient of a person I am to not even be able to do the simplest of things such as knowing what I need.

[Shaly78]

Yea just ask for diagnosis, it suppose to improve....

[d.rose]

How exactly does a diagnosis work in therapy? Is it where they're literally analyzing you for some sort of condition the moment you have your first session? Is it something mandatory that all therapists do to clients? Do you have to have some sort of condition to fit a diagnosis, if so what are some examples? If that's the case, what if you don't have any conditions to fit a "diagnosis"? Sorry if these are dumb questions, but this is my first time in therapy and I'm quite confused.

[Argonautomobile]

Originally Posted by d.rose

How exactly does a diagnosis work in therapy? Is it where they're literally analyzing you for some sort of condition the moment you have your first session? What if you don't have any condition to fit a diagnosis, do they try to find something to "fit" a "diagnosis"? Sorry if these are dumb questions, but this is my first time in therapy and I'm quite confused.

Not dumb questions.

In a way, a good T IS always analyzing the moment you have your first session, but that isn't nearly as creepy as it sounds. It's more...observation, I guess. So if you come in wearing sweat pants of questionable cleanliness and slouch sadly in your chair, an observant T (or, really, anyone in the position to diagnose) will notice that and it might prompt them to ask certain questions or have you fill out a questionnaire that might lead to a diagnosis of depression.

If you come in with purple hair and begin chatting 100 miles per hour, that might lead the T to go through a protocol for diagnosing mania ("Hey, client, glad to see you're in a good mood! How would you feel about me asking a few questions today? That'd be fine? Good. How has your sleep been lately? Ever had the impression you had special powers?")

Diagnoses should be transparent--it is always your right to know if and with what you've been diagnosed and how the health care professional came to that conclusion.

Hope that helps.

ETA: Most people don't fit neatly into a particular diagnosis. T's usually have to give one anyway for insurance purposes; it may or may not "mean" anything in your life. Some examples might be:

Client A is a 19 yr old male who comes to therapy at the request of his parents, with whom he lives. He presents as dejected and generally unhappy following an injury at work which, while not life-threatening, has made it difficult for him to resume his normal activities. He does not report difficulty sleeping, loss of appetite, or suicidal thoughts and is therefore not diagnosed with depression, but instead with an adjustment disorder. This tells him nothing he didn't already know: yeah, it's tough adjusting to post-high school life, especially with the injury and job troubles.

Client B is a 33 yr old female presenting after a failed suicide attempt. She appears in crisis and attributes this to difficulty with her significant other who is her most recent partner in a series of intense and unstable relationships. Further questioning reveals a history of trauma, self-injury, transient paranoid thoughts and a chronic feeling of emptiness. These are all hallmarks of borderline personality disorder, and the client is thus diagnosed with this. It means a lot to her; it gives a name to her experiences and she is happy to finally have a diagnosis that seems to fit.

Client C is a 25 yr old female referred by her PCP for suicidal thoughts revealed during routine screening at her annual wellness exam. Despite what the PCP has written, the client appears upbeat at the therapy appointment and babbles happily about various projects she's undertaken. Though there is no history of grandiose delusions or extreme energy that would characterize a manic episode, the clinician wonders at this sudden change of mood and will keep an eye out for anything that may indicate a bipolarII diagnosis in subsequent visits. The client could not possibly care less about diagnoses, attributes the suicidal thoughts to "being PMS-y" and agrees to follow-up visits simply because "it would be nice to have someone to talk to."

[Argonautomobile]

And to the OP--I appreciate that it can be difficult asking directly for a diagnosis, but that's absolutely your right and not at all weird.

The first time I asked, I literally just blurted out of the blue "So have you given me any diagnoses I should know about?!" and it was fine.

[d.rose]

Thanks argonaut. But, do they still do a diagnosis if you act completely "normal"?

[Argonautomobile]

Originally Posted by d.rose

Thanks argonaut. But, do they still do a diagnosis if you act completely "normal"?

Definitely. Because there's a lot of overlap between "normal" and "pathological." And because it's terribly difficult to get paid by insurance without a diagnosis. Most clients want a name for their troubles, too.

It's a much different story with self-pay clients at a private office.

Are you concerned about your own diagnosis?