? on diagnosis

Hello Everyone

I posted this on the Borderline forum; however, I would appreciate input on this forum.

I was diagnosed with BPD at the age of 41. Prior to this time-I did not have any psychiatric history. Rather, I completed college and graduate school in psychology with my clinical work completed with close supervision that is customary for my training on a psychiatric ward. My work history until the time of my diagnosis was successful. At the time of my diagnosis, I was taking the following medications: Topimax 250mg Effexor XR 75 mg, Celebrex 200 mg, Armour Thyroid 60 mg and Imitrex as needed. The Topimax, Effexor XR, Celebrex, and Imitrex were prescribed for migraines and the Armour Thryroid was for a hypothyroid. I had an EEG at this time that was normal. My past medical history included migraines and hypothyroidism since childhood and childhood epilepsy. I have no history of any prior trauma or abuse.

At the time of diagnosis, I was experiencing severe memory problems, speech and language difficulties including word find problems, extreme fatigue, no migraines, and the onset of seizures. My employer sent me for a psychiatric evaluation due to a sudden decrease of cognitive functioning and rule out any substance abuse problems. The stipulation of this evaluation was that I was to engage in any therapy, medications, or recommendations in order to retain my position. The results of the evaluation were inconclusive other than I did not have a substance abuse problem and did not posses the cognitive ability to complete my job duties. Hence, I was not covered under ADA for a disability and eventually lost my job. However, the recommendation was an in-patient program for chronic pain that included intensive psychotherapy since I was being treated for migraines. During the two week in-patient program-my Topimax and Effexor medications were increased along with an increase in memory difficulties, speech and language issues, confusion with time and space, fatigue, no migraines, and no seizures. The recommendation was an antipsychotic to treat my new onset of problems. I declined the medication. I was told that I was being paranoid for not trusting the prescribing doctor’s orders. I told the psychiatrist to bug off! The psychiatrist diagnosed me with BPD and possible psychoseizures. All my patient records were then used in employee labor negotiations.

A few months later, I saw a new neurologist; I was taken off the Topimax and put on Depakote due to a new abnormal EEG. I was given the diagnosis of epilepsy with simple partial and secondary generalized seizures. I was also taken off the Effexor XR and told not to take Imitrex since it lowers seizure thresholds. Currently all of my previous side effects have totally subsided and no longer have any of the previous symptoms. However, the diagnosis of BPD has continued from physician to physician every time someone gets a hold of my medical records. Sometimes the diagnosis comes as a secondary source from notes and comments in my chart from a different physician.

My questions are thus:

What is the best approach to deal with physicians? My diagnosis was given at one of the more well-known hospitals in the country. I did have a primary physician at one time that told me that this hospital does not make mistakes in diagnosis of a mental illness. I later switched physicians due to an insurance change. (The physician had other qualities about her care that I did like and thought were very good). I am aware that my medical records from the in-patient experience can be amended but I believe the physician’s comments are still within the charts. Please correct me if I am wrong.

Is there any possible way to be undiagnosed for a mental illness since I do not believe that I have BPD? (If you feel, I do have BPD-feel free to comment. Honestly, I do have a thick skin and it would not bother me).

Thanks in Advance

BRZO0422 wrote: Is there any possible way to be undiagnosed for a mental illness since I do not believe that I have BPD?

I've never heard of anyway to get your diagnosis removed. It's a real problem. Psychiatry is an ideology, not a science, none of it's fundamental claims, such as mental illnesses are real diseases with a biological etiology have ever been proven. There is no conclusive medical test to establish the existence of a biological marker for a single mental illness.

Why people believe in the accuracy of psychiatric diagnosis is beyond me?

I suppose we need to organise and get the American Psychiatric Association into court and demand they provide proof of their claims.

I wish I could get my diagnosis of SZ proved medically. I am so sick of the APA's platitude that the proof will come in the future.

Sorry, I have no immediate answers.

I don't have an answer either, but wanted to let you know that you most likely DO NOT have BPD or any other mental illness. Along with many, many other medications I was also on Topomax and Effexor (even though I was inpatient at a psych hospital after psychosis induced initially by the antidepressant, Celexa) they gave me these for migraine headaches as well. I can't believe that they can do this and have seen many ads recently for Topomax for migraine relief. I was put on it in 2001 I believe and it hadn't been approved for that use at that point (it was a newer anti seizure medication I believe) and after my experience and now seeing yours I have no clue how it could ever have been approved for migraines! Since they had me on so many meds and would take me off one just to put me on two more, it is hard to know which ones were actually causing me to be worse than the initial "depression" I was on Celexa for but I also went from being a productive member of society...always had a movtivated state of mind and had attained my dream job at a museum that I had worked so long for only to have to leave it and ended up on Social Sec. disability. Something I am working to change now, but how can a fully functioning person who may be suffering from stress and emotional issues go from that state to the point under the influence of medications that are supposed to help of nearly ending my life many times. The quality of my life didn't get better that is for sure! Only now that I off the meds (for about 1 1/2 yrs now) and out of the grips of the drs. and therapists making you believe that they are right and you are wrong and that your life is worse than you could ever imagine and your childhood was more traumatic than you knew, am I on the road to getting back to myself again. Sorry for the length and the 'soap box' speech, but when I see others...so many others...going through the same things I did and many times worse than what I experienced and that the media, medical community, psychiatric community, government, etc...are doing nothing it gets me going. It is all a big $ making scheme and they don't want to put a stop to that for the sake of public safety now do they? Sorry for the cynicism

Yep

I agree with Stopthemadness here. I would say don't bother trying to fight your Psychiatrist. Most of them are NPDs who just love the attention. Could you go private about your epilepsy. Sometimes being in a "helping" proffession is about whether your face fits not how capable you are at your job. It is possible that yr Dx had absolutely nothing to do with any health concerns. It may be that the symptons you experienced were due to yr coursework demands. If records are innacurate and could therefore could cause problems in gaining other employment I don't know if it's possible to have them erased. You'd need to find out a bit more about this. You sound like a pretty assertive person who's got their head screwed on the right way and you were treated like **** and find yourself in a pretty impossible position. Someone who is vulnerable and can't speak for themselves - the majority of people who see a psychiatrist has no chance. I'd definitely say make sure you have other choices lined up, career/doctors etc. It's the best way to beat the gits. Hope things work out for you.

Hello BRZOO422,

Im sorry to hear about your misfortune!!!

I also do the same job as you, I started 6 month ago. How long have you been on the following medication? Was the psychiatrist an independant one from another hospital? I assume so because of confidentiality. Have you had a bad experience personally in life in general or been ina bad situation at work with a patient that has affected you? I dont mean to seem patronising its just to get to the root of the problem! Your lack of concentration sounds maybe as some kind of stress or the other thing to rule out is PTSD which many mental-health professionals can suffer with as a shock of a patient comitting suicide etc. Which I probably think you will maybe already know this. BPD illustrates self-harming behavior and maladaptive attention seeking, have you seen any traits???
Have you had any conflicts at work with other members of staff?
I know where I work it can be very clicky, also as someone stated is rare but true psychiatrists can also be NPD and also not all nurses as you know agree with Psychiatrists. Please message me privately if you would like a chat or if I can be of anymore assistance x

First of all, I have heard there is a special warning not to take an antidepressant if you have a thyroid problem, as I do and did when I started taking Zoloft. According to Peter Breggin (a psychiatrist who has practiced medicine for over 30 years and never prescribed a drug or involuntarily hospitalized a patient), SSRIs can cause hypothyroidism, I don't know if that is the reason for the warning or not. There may be some other problem the drug companies won't tell us about.

Effexor is like Wellbutrin, I believe, it targets several neurotransmitters. I learned at a lecture I attended a few weeks back (given by a pro-drugs psychiatrist) that Effexor and Wellbutrin have the worst efficacy of all the new antidepressants. It took about 12-15 studies for each before they could come up with two "positive" studies to approve those drugs. He also said that the biggest problem is giving new meds or raising the dose of a med to counteract new symptoms which are side effects but get confused for the patient's underlying condition.

Bipolar disorder is also triggered by taking antidepressants, though doctors will say it's just a trigger and not a cause. I disagree with that.

My brother says the migraine prevention meds don't work. I think he or his wife has tried them.

It sounds like you have one of two options in dealing with doctors:
1) Establish a new doctor and don't list your prior psychiatric history and try to start fresh
or
2) Go to your doctor and explain why you do not want to take any more psychiatric medications and you just want to manage your seizures if possible without doing more damage to your brain.

I recommend you read up on the brain damage caused by meds, go to www.breggin.com for more information.

Also there are several links to related websites if you go to my new yahoo group, and we would love to have you as a member.

http://health.groups.yahoo.com/group/chaada/

I totally identify with your story of going crazy and being confused, etc. on meds.

There's a great book about managing your symptoms without meds, it's called Anxiety and Panic Attacks by Robert Handly. I used it to learn relaxation and coping skills and meditation, even though I didn't feel as bad off of the meds as I did on, I still have anxiety sometimes and I use my new skills to help myself deal with it if it starts to get in the way of having a happy mood.

If you still feel lingering effects of "BPD" that will probably go on for months until you get the meds completely out of your system, and deal with the implications of all that happened to you because of the meds. Maybe a regular therapist not a psychiatrist can help you if you feel the need to get help.

It must be really hard trying to work in the mental health field and be against taking the meds, but who knows eventually you might be one of the key people who makes a difference in our world to help resolve this issue of giving harmful medication! =)

Hi Mystical and et.al.

Thank you for your concern. Also Mystical congratulations on your new position and the beginning of your career. It is a very rewarding and interesting profession. I specifically work with children and families with severe medical issues, autism, and profound cognitive disabilities.

To answer your question regarding medication, I am no longer taking any psychotropic medications. I have found that Depo-Provera to be successful in treating my migraines since they tend to be related to my hormone levels. I was never prescribed the psychotropic medications for any psychological or emotional needs but rather for migraine prevention. I have been off both Effexor and Topamax for about a year. I still do take Depakote for epilepsy since my last EEG was abnormal and on the conservative side there is a five year wait after one’s last seizure plus a normal EEG to be taken off anti-seizure medications. Happily I will my two year seizure free anniversary next month.

To answer some of your other questions:

1) No history of any physical or emotional trauma. Work was successful until my cognitive decline which corresponded with my usage of Topamax. Also I did not experience any trauma with any of patients. Occasionally I do have a child that dies due to medical problems. While I feel both bad and sad for the surviving family-it is not traumatic experience. Also, I have not experienced any problems at work. I have worked in this field for 13 years and never experience any professional or personal conflicts at work; however, I have had professional differences in a few cases which would be expected in my position. All of my employee evaluations during this time were also positive in nature. In fact, this experience with the hospitalization has probably been the most traumatic event in my life.

2) No history of any maladaptive behaviors, coping styles, or self-inflicting behaviors. In my doctorial program, we all were heavily supervised. Any indications of these behaviors would be ground for dismissal from the program with an appropriate referral. In fact, my class lost one person due to this reason. Also one does not develop these behaviors suddenly in their early forties. There are indications of these behaviors in early adulthood. Also my MMPI was within normal limits and did not indicate any psychological issues. My extensive life history interview which they spent over 6 hours completing indicated no traumas, inappropriate behaviors, or abnormal thought processes. The only thing I flunked was a timed academic achievement test achieving a score within the average range and experienced some memory problems. For example, I could not remember the year I received my Master’s degree which was an assumed degree. I had no other problems stating which year I received my other degrees. With the academic achievement test, the psychiatrist felt that I should have tested in the superior range due to my educational level. However, honestly at the time I was experiencing significant problems at work with both short-term auditory and visual memory problems. I do not recall any problems with my long-term memory skills or reasoning skills.

3) The initial referral was because I had a sudden decline in cognitive ability along with seizures while at work. The purpose was rule out a substance abuse problem. The results of the evaluation were inconclusive other than the fact that I did not have a substance abuse problem. The hospitalization was in a chronic pain management rehab program because of my migraines. Also they wanted to pin down a diagnosis. Confidentiality was lacking in this process since all results were directly forwarded to my employer and direct supervisor who then informed me of the bad news. The psychiatrist who saw me for 12 minutes or the bachelor’s level person who was the case manager refused to return any phone calls when I requested information on my evaluation results.

4) While in the hospital the psychiatrist had the following concerns: lack of cognitive ability, language problems, seizures which he thought may be due to a possible psychological problem (a.k.a. possible conversation disorder), and non-compliance with medical treatment. To answer you question about the seizures, at the time I only I had one 30 minute EEG with no spikes or seizure activity. No video EEG’s were conducted at the time. Several months later another EEG was conducted and there were spikes and I was formally diagnosis with epilepsy. I was non-complaint because I voiced concerns about the hospitalization since I was in litigation with my employer and the medical records could be used in legal proceedings. Ironically, the medical records were used in labor employee negotiations. The second act of non-compliance was when I declined the off-label use of an anti-psychotic to help clear up my lack of cognitive ability. Additionally, I displayed no hallucinations, delusions, or paranoid ideas that would warranted an anti-psychotic. This was documented in my medical records. I felt that he should look at my medications at the time and that the use of an anti-psychotic was overly aggressive and not appropriate. Lastly, the psychiatrist was frustrated that I would not admit that I had significant psychiatric problems other than anxiety over my current situation and I was a victim of past sexual or physical abuse. Basically, I told him I would not admit to psychiatric issues or abuse that did not exist. He is a strong believer that 97% of the population with any type of chronic pain have a dual diagnosis and are victims of past sexual and/or physical abuse. He felt that I did not trust him or the program and my beliefs were more consistent of BPD and was not situational in nature. To this day, I disagree with his assessment of the situation.

While I do not feel like I am losing my mind, I am angry at the while situation. It has negatively impacted both my personal and professional life. I am upset that my neurologist at the time did not properly evaluate me for any cognitive decline when I started the usage of Topamax. Also he should have been more careful with the medications of Effexor and Imitrex when I started to experience any seizure activity since they both lower seizure thresholds. Instead, my Topamax dosage was increased by the neurologist. Also, I am upset at the psychiatrists, since the neither of them considered that my decline in cognitive ability may be caused by bad medication reactions and further my offending medications were increased for a third time with increase in bad reactions. To me this would be a big red flag-that the problems were being created by medications and not a psychiatric illness. Instead the psychiatrist during my hospitalization jumped quickly on the mental illness band wagon and moved very quickly to obtain an inaccurate diagnosis within a period of little over one week. I did not even meet the criteria of BPD at the time. Lastly, my concentration problems are no longer a problem and according to my current neurologist they also were most likely due to the Topamax since it is a known reaction and ceased when I switched anti-seizure medication. Personally I am affected by the stigma attached to any psychiatric hospitalization. This is not something I share with anyone. A British researcher (Wolff, 1997) stated that individuals with a felony conviction receive better treatment than individuals with a history of a psychiatric hospitalization. Unfortunately, I have found that to be true.

Hi.

Just read yr latest. Oh how true yr last sentence is. I work as a legal secretary in the criminal dept. I'd say about 90% of our clients are in the police station for a variety of shoplifting, car theft, drug dealing, burglary; take your pick. And they're all pretty much as guilty as a puppy sitting next to a pile of poo.

For this they get free legal representation, they have a solicitor on hand to make sure the police interview is fair and the police interview itself is taped to protect the rights of both themselves at the PS. What do people get when they go and see a psychiatrist? None of the above! For starters, if tapes were used in psych evaluations then I feel it would go a long way to protecting the rights of patients. There are just too many stories of psychs noting down something completely different to what the patient actually said. By the way I feel that DSM criteria etc is basically a joke. Not in the actual criteria itself but more that it only seems to be included as lip service. Very often it doesn't actually seem to be used.

Anyway BRZO 0422 keep right on doing what you're doing! And good luck!

I am so sorry to hear about this awful experience!

I am currently in the process of earning my doctorate in clinical psychology. I doubt I can provide any information beyond what you already know, but I will try.

In terms of "erasing" your diagnosis:
Technically, this can not be done. However, due to HIPAA regulations, you have control over your records. Presence or absence of a personality disorder should have no impact on legal proceedings. If they did, you most certainly have a lawsuit.

You can have a correction added to your record. In order to due this one of two things need to happen:
1. You get re-evaluated by the therapist who gave you the diagnosis or,
2. You get an evaluation by a new therapist. If you are having problems because your records are following you, I would advice asking the new therapist to complete the evaluation BEFORE you go into detail about your prior medical history. You can even be very honest and explain that you have been given a diagnosis that you don't agree with (don't mention which one) and explain that you are looking for a second opinion.

In either of these scenarios, if the evaluator determines that you do not meet criteria for BPD, then this correction will be added to your record.

Lastly, I would suggest talking with the therapist who originally diagnosed you and ask for a formal diagnostic justification. As I'm sure you know, therapists are required to keep detailed records. This clinician SHOULD have documented a diagnostic justification when you were given the diagnosis- specifically indicating how and why the therapist believes you met criteria.

I hope this helps. Again, I am really sorry to hear about your experience. It must be especially hard for you to have had this experience with a profession that you dedicated yourself to.