Hiding diagnoses from clients

While at the psych ward they put me on 150mg Seroquel. Seroquel mainly treats schizophrenia & bipolar disorder. I thought it was for sleep, but just found out from my sister that my social worker at the psych ward said I have a diagnoses of psychotic/psychosis with features. After my sister told me that she choked up like she had just made a big mistake. Is it even legal to give me meds without telling me my diagnoses?

The only thing I've been told from my psychiatrist is that I've been diagnosed with BPD, chronic anxiety and depression (I take 150mg of Wellbutrin), PTSD. He said BPD can't be treated with meds.

I'll talk to my psychiatrist next month but I'm starting to wonder if my providers are hiding something from me. Only that that comes to mind is my 2nd day with my 1st therapist she gave me a primarily diagnoses of schizoaffective, which made me panic and trigger real bad. Maybe that's why they're hiding stuff from me?

Even severe depression can cause psychotic features. It isn't so much a diagnosis as a descriptor of characteristics you might have been displaying while you were hospitalized.

When I was hospitalized, at one point I also displayed psychotic features. It didn't mean I was diagnosed as schizophrenic or anything; I was just so severely depressed at the time that I was hallucinating. It happens.Other psychotic features might be delusions.

At the time, I was put on antipsychotics and I stabilized pretty quickly after that. It was not uncommon when I was at my least stable, for my pdoc to go ahead and add an antipsychotic to help me gain some stability.

By the way, seroquel gets used for a variety of reasons besides psychosis. My husband took it for years because just a very small dose helped him sleep. He has a pain disorder and sleeping is always a struggle.

Seroquil has several off label uses. I have never been psychotic or Dx’d psychotic but Pdoc tried me on it for sleep issues. So I would talk to your Pdoc.

I have been prescribed seroquel and I am not diagnosed with any sort of psychosis. I can view my diagnoses in the EHR my psychiatrist uses. I happen to have had access to that EHR from the other side when I worked in a mental health agency, and there isn't a way to hide certain diagnoses.

I think it's likely that the social worker made an assumption based on you being prescribed an antipsychotic rather than her having knowledge of a diagnosis you don't know about. The only diagnosis I'm aware of that is frequently kept from people is BPD, and that hasn't been kept from you.

Your sister probably was distressed at the thought of you having a psychotic disorder rather than being distressed because she spilled the beans.

Lots of psychiatrists don't discuss diagnoses with patients, so it certainly is legal to prescribe medication without disclosing a diagnosis. The reason they don't is that many see diagnoses as primarily useful for insurance reimbursement and they think focusing on symptoms makes more sense. For many disorders, this is a valid perspective. However, the etiology of psychotic symptoms does sometimes matter for treatment purposes.

On the other hand, I was once hospitalized, given a couple new diagnoses, and not informed of the fact. However, that was probably because I was a minor. It happened that the diagnoses were bogus (not surprising given I spent maybe 10 minutes total with the psychiatrist the whole week I was there), and were not added to my chart by my primary treatment providers.

Two sessions is not really sufficient time to diagnose someone with schizoaffective disorder unless they are entirely a diagnostic evaluation. I generally think therapists are competent to diagnose, with a few exceptions, and the major one is any sort of disorder involving psychosis. I think you need a psychiatrist for that because organic brain disorders/disease must be evaluated and ruled out as a cause of psychosis. Most therapists have very limited experience with psychotic disorders since the primary treatment is medication. Psychiatrists have much more experience and exposure to patients with psychotic disorders.

I guess the psychosis with features could have been added by the psych ward due to suicidal planning.

As for BPD, why is it frequently kept from the client? I can think of a lot of reasons such as it's the most difficult to handle for therapists, etc.

I used to have a diagnosis of depression with psychotic features but it was later changed to Schizoaffective disorder--depressed type. (Plus some other things). The change didn't bother me, in fact it made sense to me. But the only reason I found out the diagnosis was changed was because I asked for a bill I could submit to my insurance to get partial reimbursement and it had all the codes and descriptions on the invoice, unlike the one I receive when I pay my bill. I think it would be nice if PDOCs would tell you what the diagnosis is because sometimes there are self help books or something that can be used, or even in my case just a sense of relief at finally knowing what was wrong with me and having a diagnosis that seemed to finally fit what I was going through. All of my T's have always put down depression, PTSD (which I don't think I have even been clinically diagnosed with), generalized anxiety disorder, ADHD, and autism spectrum. So my T's have missed the psychosis part of my diagnosis. My Pdoc did a very long intensive testing process to come up with that diagnosis. I'm always open about the hallucinations less so with delusions because I don't know I am having them, but most of my therapists haven't seemed to know what to do with them.

I think seroquel is used above 300mg for psychosis, below that it’s a very effective sleep aid....that being said pdoc gave me seroquel for “sleep” when I had florid psychosis. I’m not sure what’s up with this deception but without the meds I wouldn’t have become lucid so I appreciate it but I think they could’ve been honest.

BPD is often kept from the client for two reasons. First, people with BPD often do not respond well to being told they have BPD. Second, many times clinicians will avoid even documenting a diagnosis of BPD or acknowledging it due to the stigma. They don't want the client to have to carry such a stigmatizing label.

Unless your suicidal planning involved distortions of reality or something, that would not be a cause for diagnosing psychosis. Nobody thinks people who plan to kill themselves are psychotic just because they're suicidal.

Is it just me but after taking 150mg of seroquel for two weeks now I can't tell anything. First time was only 50mg and I saw blue stars for awhile lol. Then 150mg in just 40 to 60 minutes my body felt heavy. Now, 150 mg after 2 hours later and I feel nothing.