Friday, October 5, 2012

Relief Is On Its Way: Initial Diagnosis Part 1

On average, there is an eight-year lag between a first episode of depression or manic symptoms and the first time the disorder is diagnosed and treated (Goodwin & Jamison; Lewis 2000).

Usually individual’s first stop is to their primary care physician. While some physicians’ have a little experience treating psychological issues, their primary role is for regular medical issues that are not emotional in nature.  Psychiatrists really are the type of medical doctor that specifically and solely deal with mental and emotional issues.

It has been my experience from discussing this topic with others, that their primary care physicians more frequently prescribe Prozac whenever a patient complains of depression. Their repertoire usually does not include a supplementary understanding of additional medications like anti-depressants and especially mood stabilizers!

What happens upon making that initial appointment to see a psychiatrist? For me it was fear… a “what happens from here on?” kind of feeling. This is what I have found and still find the most important piece of the puzzle, of getting your life back on track. Something I will call “the discovery.”

Nobody jumps up and down when they are first diagnosed with a mental or psychiatric illness. Personally, for me I went through the, shock, blame, anger, and acceptance phases’ sort of equivalent to the stages of loss. I thought my life was over and I could see no light at the end of the tunnel. Even now after 15 years, that light comes and goes!

The average person diagnosed with bipolar disorder experiences four episodes per year during the first 10 years of the illness.  Like any mental illness, there are no limits to who will acquire a diagnosis. Old or young, female or male, rich or poor, etc.

One fact I found very fascinating is men tend to start in the mania phase while woman tend to start initial diagnosis in the depressed phase! Note to person’s with bipolar, woman are not the only dramatic ones!

For me, I feel the bipolar diagnosis is much more stigmatizing than depression. I cannot tell you how many folks, who do not know about my bipolar, will make comments like “that person is so wacko, she is bipolar,” or “you never can predict if he is going to be unstable”! It is easier I think to understand “being depressed,” that usually equates to a low or sad mood. However, for those who don’t understand it “bipolar” means folks are all over the place, up and down.

 So after you get the courage to make that initial appointment to see a psychiatrist, make sure you feel comfortable with him or her.  This is where the discussion regarding treatment and medication begins. From experience with various psychiatrist’s I have found that the same steps take place. Initially, the psychiatrist sits down to discuss what brought you to him or her. I have found as if this is almost like a job interview. Your road to recovery needs to happen in an environment that will help you progress further. I can vouch. I have had really great, intelligent, warm, and non-arrogant psychiatrists’, and I have had intelligent rude psychiatrists. It is hard sometimes to decided, do you want smart with no interpersonal skills, or a more caring one not as informed. It is your call. Yes, I know this does not make the choice easier.

The psychiatrist usually wants to get an idea of what brought you into the office. What symptoms have you been experiencing that is so difficult that you feel medication might be useful? In addition, the doctor probably will discuss your life from birth to present age. This takes place to see if there has been a pattern and/or how long your symptoms have been in existence.

So have your medical history available, with current and past doctor’s information in the case the psychiatrist needs to discuss other medical issues. As well as past medication use, for any other health reason.

This topic could go on and on. I have chosen to end it here and write a second part to this later. More along the lines of “what continuous care” looks like after the initial psychiatric visit. Please provide comments for those going through this difficult time in their lives!

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