Does diagnosis matter?

I just got home from seeing my pdoc and he changed my dx to schizophrenia. no med changes though and I think Im on the right ones. From my perspective, does the diagnosis matter?

I'll offer my dissenting opinion--

Yes, it does matter when you're talking about BP vs Sz -- but only to a small degree. BP involves severe mood dysregulation. While Sz can involve mood dysregulation as well (typically depression from what I understand), mood stabilizers aren't a "standard" form of treatment for Sz. However, that doesn't mean someone with Sz can't benefit from a mood stabilizer. Mood stabilizers are used in people with autism to treat aggression, even though mood stabilizers are indicated for bipolar. But symptoms wise, Sz and BP are different and I think they need different methods of treatment in therapy. Medication is another story, but if you've found a cocktail that makes you feel better, then it doesn't matter what your diagnosis is. You want to treat the symptoms, not the label. But therapy speaking, yeah, it does matter. It also may matter for insurance purposes in terms of what medications your insurance will cover for you. For example, they may not cover a mood stabilizer anymore, so keep an eye out for that. You may need to appeal their rejection if they give you a hard time.

My psychiatrist and I were one time wondering if I might be schizo-affective disorder instead of bipolar because i was having delusional thoughts outside of obvious mood episodes but he eventually settled back on bipolar because my constant dysfunction is in the area of mood, my complaints are about ongoing depression and a lack of interest in things outside a very small world. The good news is that world is expanding. I am finding a fitbit very helpful in monitoring my sleep. i also am losing insight the more delusional i get when I start to believe intrusive thoughts that get stronger and more persistent.

That's why I take a low dose AP every day.

In one sense, I don't think the diagnosis matters, as long as you receive the right treatment to help ease negative symptoms. But I think we all want to know what we're really dealing with in life. I can't speak for others, but sometimes mystery is painful. It can be easier to ground oneself when you can understand the "whys", "hows", "whats", and "what to dos".

I don't believe the diagnosis matters as much as people make it out to be. Most bipolar types and Sza's are treated the same way medically for the most part.

It does to me. I just gout of ip where my dx was changed to schizoaffective

My diagnosis is up in the air. I wish I knew one way or the other. I've spent a lot of time researching bipolar disorder and working with the suggested methods of managing it. I now wonder if I am even doing the right things. I have been healthy for a while now so I am going to stick with it until I know something concrete, but it sucks not knowing for sure whether or not I'm on the right path or if there is more I could be doing for myself. Either way, I relate to what so many of you have shared. I plan to stick around.

It doesn’t for some. For me personally I need a diagnosis to keep me compliant. The way my brain works is: no diagnosis = no meds needed.

I believe that diagnosis matters in the sense that it leads to the correct treatment. I used to be diagnosed with PTSD and Major Depression and my life was hell all the time as I was on antidepressants which I have since found cause mixed episodes in me. So basically I was left in a constant mixed episode for several years. Not fun. Once diagnosed everything made sense. It took a few years, until this year actually, to find the right med combo but the diagnosis led to that. Without the diagnosis I hate to imagine where I would be now. I still carry the PTSD diagnosis but it is mostly under control and only flares up if I suffer new trauma.

I think it kind of comes down like this: If your symptoms are being taken care of, it doesn't really matter. But if knowing is helpful for you in any way, then yes, it matters.

That's my take on it anyway...

*********
Mr. Robot

Makes me sick to the heart, Oh I feel so tired. And the way the rain comes down hard, that's how I feel inside.

--The Cure

I think diagnosis matters. If you had cancer, wouldn't you want to know what kind?

DX is tough in the mental health arena. We're mostly just treating symptoms and the DX is essentially based on that. You could have a different dx based on what doc you see, or when you see them. Symptoms for different conditions can look very similar, and it's up to the judgement of the doctor what label to place on you. (It is important for the doctor to have a diagnosis for you because without it, he/she is not getting paid) For many of these symptoms, the treatment is the same.

The doctor works with you and you make a plan to help minimize symptoms and episodes. I think it is important to have a dx because it can give guidance to other health practitioners. For example: I go to my primary care and tell him i'm depressed. He wants to provide a script for Zoloft. He sees that I have a dx of Bipolar Disorder I and realizes that the antidepressant may be a bad idea.

If you're getting the right treatment, I don't think the DX is very important. It's all a spectrum anyway. If you ask me, everyone is a bit bonkers. Some are just better at hiding it.

Without going into a lot of detail, I think a diagnosis is important. For years I wanted to know what was wrong with me. Why am I the way I am? Once I had a name for it I felt a sense of relief! There was a name for the madness I was suffering from. I did my research about the disorder and that helped me to understand my symptoms. Ever since then, I feel like I have a better 'grip' on this illness so that i can get treatment when I need it.
I also think having the diagnosis is for billing purposes for the doctor.

My dx of schizoaffective bipolar type ultimately led to the type of meds/ treatment that helped me the most however I do think that there's a spectrum with mental illness and there can be a lot of overlapping symptoms. The main thing that changed when my dx changed from bipolar to sza bipolar was that instead of just moodstabilizers and low to mid dose APs I got on a really strong high dose AP along with the moodstabilizers, which targets the psychotic symptoms that tend to be more constant in psychotic based disorders.

Anyway, many types of meds are used for multiple purposes, so I while I think having a correct diagnosis is very helpful and important, I don't think it's as big of a problem if you were to say be dx with something entirely different than schozophrenia or bipolar spectrum disorders like diagnosing someone with something blatantly wrong or not even close to the mark

For me the diagnosis matters. When I was diagnosed Bipolar ! and put on a mood stabilizer my world stopped being so chaotic and despairing. I have more stability now. I wouldn't have had that with a depression/BPD diagnosis. I wouldn't be put on a mood stabilizer at all, just another AD and another reminder to use my coping skills.

Diagnosis matters because it determines proper medication and psychotherapeutic treatment. That's why MDs and therapists have to be in agreement. They cannot work at cross purposes. It's stressful on patients and the outcome is poor. MDs have the upper hand in determining acceptable diagnoses, particularly involving medication. Some people do Dr. shop to get a diagnosis they find desirable. I truly don't know why anyone would actually want a particular diagnosis, but it happens.

Think of it this way, would you walk into your primary care doctor's office and not care if you had pneumonia or bronchitis? Like wise would you walk into your primary care doctor's office and insist he diagnose you with a brain tumor when you actually have a sinus infection? The correct diagnosis really does matter.

Yes and no. I have bipolar 1 (“severe” *rolls eyes*, rapid-cycling, mixed with occasional psychotic features).

A few years ago, my T suddenly (?) thought I might be schizoaffective. I do get serious psychosis of various types but only during mood episodes (I think).

My pdoc said the bp 1 with psychosis is correct but he paused - he is cool -
he said, “Rainy, even if you had sza your treatment would be the same.” And he said we treat the symptoms and the labels are secondary.

I did buy the book titled Surviving Schizophrenia—cannot recall the author and I am not home. But it is EXCELLENT. If one never has psychosis, do not bother.

The doctor that wrote the book has a sister with schizophrenia. And I know we may be saying schizoaffective or whatever. I relate ALOT to that book. I think it is a spectrum.

He also wrote Surviving Bipolar Disorder.

Tolley. Toley? Cannot recall the author.

That book is worth reading. I have had a few psychiatrists that evaluated me “suggest” schizophrenia but my pdoc knows me best. I DO personally know my psychosis is always during an episode.

So. There is info. I hope it helps. I think Knowledge is power. Get the book and PM me anytime. xx

I think it both matters and doesnt matter. It matters because very often we want a name for what is wrong with us and a doctor wants to know what direction to move in to treat us. With mental health since there are no physical tests- its sort of like looking at a group of symptoms and plugging them into various diagnosis's until you find one that is more likely than not that applies to you. Mental illness diagnosis is tricky and not text book and I know a lot of people get upset when they are given a wrong diagnosis or mixed messages (rightly so). I think where it might not matter is when the theories are very similar. Maybe finding out you have a schizophrenia or schizo-affective diagnosis isn't as important as treating them if the treatments are similar. And in many cases mental illnesses are so similar and "cross" over each others' lines. Bipolar I& II can seem very similar to one another in depressive symptoms but the mania part can feel very different. This is where a very thorough p-doc can come into play. I personally would be very wary of being given a diagnosis after 15 minutes with a p-doc that just met me. That is not to say a diagnosis after 15 minutes would be wrong its just that I believe more time to at least rule out other things can be helpful.

Surviving Schizophrenia is a fantastic book! The author is E. Fuller Torrey

I feel like needing to know the name of your mental illness is essential to accepting your fate and starting to heal.

I was dx with Major Depression with Psychotic features because I was saying I saw things that weren't there. However that dx was upgraded to Bipolar almost 10 years later and my life is making perfect sense now.