I Disagree With My Psychiatrist

[joeylittle]

The scan confirmed PTSD brain changes I am told.

No such thing; there's some research, and certain kinds of changes in the hippocampus have been observed in PTSD subjects...but there is not currently any brain scan that can lead to any conclusive diagnosis.

Growing up in an unstable home environment can contribute to a number of mental health issues. If you are showing all the symptoms of PTSD without actually having an identifiable trauma, and you've also experienced psychosis/hallucination - it is possible that you could have an aspect of a factitious disorder. They are complicated. It's not really 'making stuff up' - not always, certainly.

In other words, you may not be aware that you are mimicking certain kinds of symptoms; from your perspective, they could be quite close to real.

I'm not saying that's what's going on.

I am saying that it's very good you are going to get a second opinion. And if you are anywhere near (or have resources to get to) McLean Hospital - Dead Link Removed

They have an extraordinary psych program. One thing they offer is a very detailed, focused and thorough diagnostic process. I believe it lasts 2 weeks.

 

[Deleted member 541]

I agree that an MRI can not show PTSD. I've had numerous Brain MRI's for a multitude of different issues in my life, and no dr has come back and said, that my MRI showed PTSD......

 

[screen-name]

I don't really feel the need to defend information that was said by two doctors. It's not what I came up with. They just mentioned the MRI so I thought it would be useful to you guys here.

I have had both an absolutely crazy mother who had severe mood swings and was violent as well as a physically abusive spouse. So, the "assumption" that the PTSD came from my mother is based on the fact that I was child which made me more vulnerable than during adult experiences but since I didn't see a doctor until after the stuff with my husband, they aren't going to say exactly when it started. I just didn't really want to share about my past at the moment. Once again, this is from others and not my own idea of when and they decide things..

There are several details in a factitious disease that are lacking for me. The need for a type of gain, either financial or emotional. Financial being totally ruled out, that leaves emotional. I am not talking to people about this except two family members and this forum because I thought that's what it was for. It is not increasing my support group or allowing me to get out of any responsibilities.

He told me to look up Ganser when I left and the two biggest symptoms for that are approximated answers and amnesia of the events. I do/have neither of those.

I am also unwilling to spend time or money on testing to keep trying to figure out what's wrong.

I really have just been feeling depressed lately and want help with that. I like to give my doctors a full idea of what's going on for two reasons 1, I'm not a doctor so I don't want to filter things to fit a diagnosis. 2, I thought that's what you do.

I guess it's difficult to really explain everything on these sites. I can't write a book giving full background to things. Things got worse for me last year because my ex dragged me through multiple DSS cases at the same time he started a year long custody battle. The time it took to handle the things that he started caused me to do worse at work (because I was at meetings, with my lawyer, or in court) and to lose my job. It was a terrible and very difficult year, but I kept my home and won all of the cases so it was a success overall. I like my current job.

My ex is the biggest reason that I would never want to be diagnosed with anything terrible or debilitating. If that were to ever happen, he would come after the kids and I would lose everything that matters to me. It would not matter if people took care of me because I was some kind of sick victim because I wouldn't have the most important things in life. There just doesn't seem to be a reason for me to appear to be anything but what I am.

Those closest to me know how much I give to others and how little I ask to be done for me (which is the opposite of someone with a fictitious illness). I've been trying to figure out, or I could even say I'm confused about, what I am saying in particular that makes it sound like I think I need more than I really do.

 

[Freedomfighter]

Ok. I don't respond to others on here as much as I should so I feel a little guilty posting my own...

Well, you need strong guidelines, a good road map of sorts, often we get stuck in addressing multiple problems at once. It might help to ask your psychiatrist what he thinks is the most important to be addressed. Depression if not treated can get deadly no doubt.

In my opinion your psychiatrist should address the suicidal tendencies and depression first. Easier said then done because so often so many symptoms are jumbling around in our heads.

Just ask your psychiatrist what he thinks should be addressed first, that might give you some needed insight.

 

[Sandstone]

In the UK Ganser is classified as a dissociative or conversion disorder, not a factitious disorder. What is making you link the two?

 

[Riot]

I have no idea how true this is, well, because Wikipedia... but I did read this awhile back, and thought I'd put it here...

"Factitious disorder and malingering cannot be diagnosed in the same patient, and the diagnosis of factitious disorder depends on the absence of any other psychiatric disorder."

From my understanding, if you've already had a diagnosis of PTSD, this does seem strange that your psychiatrist would 'add' it on afterward.

On a different note, I also wanted to say that I am sorry you're so confused over your psychiatrist telling you to Google it. Having a diagnosis thrown at you is hard enough, without being told to just figure it out on your own. I mean, look at it this way. If you were making it up, or even unconsciously mimicking symptoms, having you ruminate and obsess over technicalities because your doctor gave you vague brush off? Dirty pool, in my opinion.

I really think you need to speak directly with the doctor that mentioned it and get to the bottom line about it. If you can't, it certainly sounds time to move on to a different specialist.

 

[screen-name]

In the UK Ganser is classified as a dissociative or conversion disorder, not a factitious disorder. W...

I actually just posted that he said Ganser. Other posts on here brought up Factitious. It was originally seen in prison inmates as a way to be diagnosed "insane" and get better living conditions and then it was moved to the dissociative spectrum so depending on where you read everyone on here has been correct in what they said.

If I'm subconsciously doing it then I can wrap my head around that. If he's saying it's something that I'm doing for attention then I am failing miserably lol because it's not benefiting me at all. He gave very little clarity.

 

[joeylittle]

If I'm subconsciously doing it then I can wrap my head around that. If he's saying it's something that I'm doing for attention then I am failing miserably lol because it's not benefiting me at all. He gave very little clarity.

A little more reading later....so, Ganser is technically no longer a diagnosis in the DSM 5. It had been a factitious disorder, but was moved to dissociative disorders in the DSM IV-TR. It seems to always have been acknowledged as incredibly rare. And, as @Sandstone said - it's still in the ICD-10 as a dissociative disorder. I'm going to guess that it was previously classed as a factitious disorder there, as well.

All that just adds up to: it's one of those mental health things that has a name, a set of symptoms, and very little else, comparatively.

He told me to look up Ganser when I left and the two biggest symptoms for that are approximated answers and amnesia of the events

On the surface, it looks like he's trying to find an explanation for the voices you have been hearing, taking into account the recent extreme stress you were under last year with your ex.

Honestly - I think you owe it to yourself to get a second opinion. Whether this doctor is right or wrong in their approach to your treatment, it's impossible to say; maybe what they are suggesting would work well for you. BUT - it's very strange, to me, that they aren't willing to talk more openly with you about PTSD, originating trauma, and the very broad range of symptoms that can be considered under PTSD.

I know you said you don't want to spend excess time/money on chasing diagnosis - but, is seeing another clinician even an option? It might be useful for you also, in that you're generally questioning your own experience of your symptoms...so having them evaluated by a second party could give you a different perspective.

 

[Riot]

100% agree with @joeylittle.

 

[Nessa7]

I can't get past how weird that diagnosis is. I'm sure that someone has reimagined it since the 1800s, but the first thing that comes to my mind is that you've been diagnosed with the male prisoner version of Freud's hysteria. I'm not a medical professional, but I did read some of Ganser's case studies in college, and they aren't similar to what you're describing. I wouldn't be able to trust a doctor that gave me that diagnosis unless they explained how they came to that conclusion and why other diagnoses don't fit as well.

 

[talon]

Ok. I don't respond to others on here as much as I should so I feel a little guilty posting my own...

Writing things down is good advice and it can't do any harm . I looked after someone with 20 alters and that's how they communicated and by email i being the in between communicator. Ganser syndrome is a rare dissasociative disorder previously classified as a factitious . It is characterized by nonsensical or wrong answers to questions or doing things incorrectly, other dissociative symptoms such as fugue, amnesia or conversion disorder, often with visual pseudo hallucinations and a decreased state of consciousness. It is also sometimes called nonsense syndrome, balderdash syndrome, syndrome of approximate answers, pseudodementia, hysterical pseudodementia or prison psychosis. This last name, prison psychosis, is sometimes used because the syndrome occurs most frequently in prison inmates, where it may be seen as an attempt to gain leniency from prison or court officials.

 

[screen-name]

Hey every one. Thank you for the responses. I took some time and stayed away to see if things calmed down. It's about the same though.

I'm going to look for another opinion and see what they say.

I think the diagnosis is very odd too because it's so rare and I can talk or answer questions fine.