How Important Is Formal Diagnosis?

[Iam]

Last May I questioned the diagnosis I was given of PTSD by a pyschiatrist and two councelors, including my present therapist. I am now wondering again about the dx. PTSD has only been mentioned in passing to me by them, that they "believe" I suffer from it. When I looked at the original mental health notes from 9 yrs ago MDD is the "formal" diagnosis. My current T said he doesn't want me labeled with PTSD even though he thinks that is what my problem is. Turns out, when I asked him about going on disability, that in order for me to be formally dx'd with it I would need to go thru a battery of tests by my PCP and a psychiatrist. So I am assuming that is why he didn't write it as a formal dx.

So my question is this.....if, even though 3 professionals have told me that I have ptsd, should I find a professional who specializes in dxing it? Does it matter? Anthony would probably say yes to this, but IDK.

If the answer is yes, how do I approach my T without offending him?

 

[AdamAnt]

Sounds like your T is trying to keep your options open should you decide to go on disability in the future? Sounds like he's trying to save you from having to go through all the red tape and maybe it's an easier process with the MDD dx. I'd listen to him!

 

[Iam]

Ummm...no, just the opposite. He does not agree with my having quit work and doesn't want me to go on disability at all. He feels that it would limit my employment options in the future and wants me to be working at leat part time. He thinks it would be hard for me to even get disability given my past successful sales employment in marketing. I also take care of myself as far as appearence goes, which does not fit with MDD. I guess the fact that I am able to fake it most of the time means that I am not so bad as I sometimes feel and act? IDK.....that kind of pissed me off or at least confused me.

I discussed going back to work as a substitute teachers aide for special needs kids with my husband. He likes the idea. I love working with kids. I did it years ago as a favor for a friend when her co-worker had to go out on disability for several months and also subbed in at other schools. It was very rewarding. Unfortunately my husband lost his job so I had to go find a stable, high paying job again. I've always managed to do what I "Have" to do for the family. I don't have to make much money anymore and really can't handle that kind of stress.

Sorry for the rambling.

 

[Nicolette]

Iam, branding/labeling with a diagnosis can affect future employment if there are allowed to conduct medical history tests on you.

In Australia we have WorkCover (now WorkSafe) for injuries which occur at work. Unfortunately some people destroyed it for the rest by abusing the system and giving it a bad name - using it for disability while just not wanting to work and faking injuries. The consequence of that, or illnesses which people cannot see (I had a back injury) means that you are pre-judged and placed in a 'category'. If you applied for a job and were matched against someone with the same qualifications, with another person having no medical history to that extent, the other person would get the job hands down. I think this is where you therapist is heading.

Due to my situation, you had to disclose whether you had any previous WorkCover claims and as I did no one would employee me. I thought stuff all of you and have been successfully running my own Company for 10 years now. So it's really about what you want and how, if at all, the diagnosis with affect you.

 

[Iam]

I understand what you are saying Nicolette. I have decided not to try for Social Security Disability for that reason. Who knows what I may want to do in the future as far as working goes and it makes sense not to do something that may limit that.

My question about submitting to or even requesting the battery of tests for a formal, no doubt about it for me, dx of PTSD was more regarding how important for my treatment in therapy is a formal dx needed? It's obvious that I am going from bad to worse going thru this therapy of dealing with all the past crap. If I don't truly have PTSD maybe it would be better that I NOT do this and instead just forget about the past and focus on learning new coping skills for present situations. Does that make any sense?

 

[Nicolette]

If I don't truly have PTSD maybe it would be better that I NOT do this and instead just forget about the past and focus on learning new coping skills for present situations. Does that make any sense?

Yes it does make sense Iam. It's not the PTSD dx which is the question.......it is are you ready and in a place where you can deal with your trauma?

I was going to therapy and was getting worse with both the therapist and my doctor both telling me that, maybe for me, digging up the past is not the right answer. I made some changes in my life like cutting out contact with some family members and I gained more relief from that than months of therapy. Not everyone can deal with digging up the past, maybe the focus could be accepting it if you have not already and just learning better coping mechanisms? Had I kept going to therapy I think I would have had a meltdown as it was just too much pressure for me to bring up things which I had laid to rest in my own way. The experts may not agree but it was the better option for me.

 

[Iam]

I totally understand with what you are saying and think that it may be true for me as well. I thought I had come to terms with it, I certainly forgave my parents. My dad has changed so it's easier to have a relationship with him. In fact we were really close, but the dredging stuff up and getting new memories of what happened have changed my feelings for him. So now I do think I need to deal with forgiving him again. I didn't talk with my mom for 10 years and have only started speaking to her again in the last 3 yrs. She was fine in her communication with me until May of 2009. Now I have have had several episodes with her. Usually I handle them ok, realizing that it is her issues not mine. This last one did me in though. Funny thing is.....she really was much better than usual. I mean she left messages with vicious remarks but she didn't rage as usual. My expectation that she would cause HUGE anxiety for me. Oh well....I don't know what the right thing is to do. Guess I need to just put it on the back burner and see what happens.

Thanks for your imput Nicolette.

 

[Jacquie]

They wont change and we cant change them. Accepting that we cant change them (the struggle) means we can see them 'as they are' and its as they themselves want to be. The conflict only arises if we have an expectation of parental love or understanding which 'we might see' as how a parent should be, but they dont.

Solution? Be the parent you know to be what a good parent is (your choice) but let them make their own choices (to be whatever they want) but while understanding that when you were a kid, you had no choice. You were stuck in it. As a kid, you were stuck in it. You're not stuck in it now, but you cant change them or how they want to be either.

Could they change you and make you like them? No. And you wont change them either. The problem lies in that conflict of each expecting the other to somehow change into how they expect them to be.

Look at your parents as people you would meet on the street or at the bowling alley. As strangers. Just see them. We all make decisions as to whether we'd want to talk more with someone we just met, or maybe ask them over for a coffee or get to know them more.

Look at the parents 'as they really are' standing there. If they were strangers, would you want to get to know them more. Would you feel safe inviting them into your private life?

Thats the point you work from. If yes, then treat them the same as you would those strangers. Usually at a safe social distance for a while. And if they go agro on you, treat them 'the same' as you would that stranger you invited home for a coffee.

But if you look at your parents and see people you would not normally encourage any closer relationship with. Walk. Do the same as above. Treat it 'the same' as you would any other person you meet on the street.

Then it lines up with your own choices and your own beliefs and your own life....as you have chosen for yourself.

It doesnt always mean one is right or one is wrong. Sometimes people are just 'different'.

EDIT: I am not a psychologist or psychiatrist. The above is only my own thoughts and how I see it. It should not be taken by anyone as direct advice.

 

[Ted Moen]

People have symptoms. Most symptoms are characteristic of more than one diagnostic catagory. A formal diagnosis is a professional opinion of the diagnosis your full set of symptoms most characterises. The formal diagnosis is important in the process of receiving benefits, such as VA or SSD. In therapy the focus is on the symptoms. If you are not seeking benefits, the diagnosis is not really important, with some exceptions. Being diagnosed with a personality disorder as opposed to an anxiety or trauma based disorder can significantly change how the professional community is likely to approach your treatment. My therapist, a clinical psychologist specialized in ptsd, would not be inclined to take on a person diagnosed with a personality disorder. Your therapist seems to be more focused on treating the symptoms than the actual diagnosis, which is a good thing I think.

Ted