Well, I woke up at 1pm and went straight for the cookies again, so you know what that means.
Maybe you don’t.
I probably don’t either.
Anyway, let’s talk about diagnosis!
I wonder if there’s a diagnosis for “always being paranoid about being followed and watched by demons or someone/thing or some shit at night” and “frequently hearing voices screaming and mumbling random phrases like ‘LOOK AT IT!’ and ‘ARE YOU AWAKE YET’ when you’re really tired” because I have a rampant case of whatever that is.
Well, I know hearing voices when you’re extremely tired, going to sleep, or waking up, has it’s own category: hypnogogic and hypnopompic hallucinations. Typically you just hear your name or a phone ringing or something. Neither of those have happened to me. Not that simple, at least. I hear my name often in public though, and I’ve heard a megaphone guy shouting across campus but there were no megaphones around so I’m like whatever dude, I don’t have time to investigate this shit brain, stop dicking with me and focus; we have integrals to do.
This semester I was standing in line to get my chem lab book and my boyfriend was about three people behind me and I kept hearing my name being called so I spun around about three times and he’d always be looking at his phone and we all know I don’t know anyone else in that hell hole. The people behind me kept giving me looks like:
It’s okay though, their little brains can’t understand the magnitude of my weird awesomeness. When I’m rich and famous I’ll come back and pimp slap them with some baby powder on my hand.
I sort of have a diagnosis, kind of. Social anxiety disorder and depression are definite; the others, I’m not sure about. I’d say I have symptoms of whatever they wanted to label me as, but I’d much rather focus on the symptoms than jumping back and fourth between a diagnosis. I mean, say if I were seeing things and hearing things that weren’t there and I’m paranoid that my neighbor has put microphones in my apartment to study my breathing patterns so he can . . . steal my lungs . . . but I also kind of fit diagnosis for Bipolar when I’m not freaking out about my neighbor and hallucinating–I’d much rather them focus on the things that are actually lowering the functionality of my life than whether or not I’m schizophrenic, bipolar, or schizoaffective.
Diagnosis isn’t entirely important for treatment, not in my opinion. You have a list of symptoms in front of you. So treat them. Who gives a shit what you want to call it; we all know that’s just for insurance purposes anyway. Unless you want a diagnosis then I’m 100% behind you. It’s all about you and what you want.
Of course, if you’re really disconnected from reality, it’s probably a good idea to get a sense of what you’re going through with diagnosis because it would help you realize you haven’t been experiencing reality. But it also might get this pesky thought into your head that you’re sick, and ill, and perhaps deserve nothing better.
It also makes people freak out. If I had a nickle for every time I saw an “Am I schizophrenic?” question on Psychcentral, I’d be Bill Gates swerving in a Lamborghini right now. If you have to ask that question, you’re probably not.
I mean, most of them aren’t even close! People hear the words in every day life and they WebMD the shit out of it, see that the website lists “Angry Outbursts” as a cue to schizophrenia and people go “fuck, fuck, fuck, I got angry yesterday, shit! I’m schizophrenic!” And they’re running around their house sweating because now they’re starting to notice other symptoms. One question I read on the “Ask A Therapist” column had something to do with a kid who had chronic knee pain and he equated that to schizophrenia. I don’t know how, but he did. I . . . what . . .
I started reading all sorts of psychological things when I was a teenager and yeah, I thought my behavior fit a lot of disorders. So I’m going around thinking “shit, I’m crazy” and i’m 100% sure I imagined half of the symptoms just because I read about them. It’s dangerous to self-diagnose, I think, especially when you don’t understand the full gravity of the stereotypes that come with calling yourself mentally “ill”.
But diagnosis will always be there. I’ll never have a problem diagnosing someone unless they’re adamantly against it. What I am worried about is the APA tossing bullshit under a diagnosis and calling it a problem.
One of the things people were worried about–Including many of my psych professors who were in and have been in clinical practice–when the DSM-V came out was the fact that 1) they took out a section in the back of the DSM IV that gave you a list of environmental and social reasons for people’s behavior that you could list via code with your diagnosis and 2) they were coming with a lot more disorders that they figured preceded other disorders.
At least they got rid of the schizophrenia sub-types (I.e, paranoid, residual, catatonic, disorganized, undifferenciated). Finally.
I have the DSM-IV and DSM-V and I laughed at the fact that these people tried to get “Attenuated Psychosis Syndrome” into the DSM-V. I mean I physically laughed. If you don’t know, attenuated psychosis syndrome is basically listing the symptoms of someone who may develop psychosis in the future. I’m sure you and I could think of at least fifty reasons why that’s a bad idea.
This guy, Allen Frances (MD) said it perfectly: ” ‘Psychosis Risk’ had been DSM-5’s most feared and controversial proposal because it doesn’t do a good job of actually predicting psychosis and might well cause stigma and exacerbate the already existing, wildly excessive use of antipsychotic medicine in teenagers.”
I mean, duh. Doesn’t take a genius to figure that shit out.
And “Intermittent Explosive Disorder” and “Disruptive Mood Dysregulation Disorder” or, what I like to call “Slightly aggressive tantrums”. If your kid is hitting people 24/7 and screaming and being deliberately deviant that’s a whole other story. But these disorders are so easy to over-diagnose it’s disgusting. Any parent who finds their kid hard to deal with who takes them to a doctor who could really care less about looking deeply into their behavior as a child and your behavior as a parent is going to toss them a diagnosis and have them labeled as an “ill” child. You know what that does to a kid’s self-esteem? If you tell them they have a problem they can’t control? Whether you say it blatantly or not, they’re like sponges, they’ll pick up on it.
And if your doctor is stupid enough, he might prescribe your 7 year old medication and then when they’re thirteen they’re having all these weird ass tics and mood issues because no one allowed their brain to develop like a normal brain. I watched a case study in one of my previous psychology classes of children being diagnosed “Bipolar” at ages 6, 7 and 8 and by the time they were teenagers they were 1) fully convinced they were ill 2) fully convinced they couldn’t live without medication but hated that “fact” and 3) had all these odd physical symptoms, including aches and the development of a tic disorder.
One of the children had actually had an odd, manic-psychotic type episode (they had tapes of the therapy sessions) so she’s a different, rare, case.
One 5 year old was placed on mood stabilizers because he was “Bipolar” and he’d often sit in front of the computer and repeat the phrases “everything is hot, everything is hot, everything is hot” and the camera man was like “what do you mean everything is hot?” and the kid just stared at him and kept repeating the phrase. He’d do this with other phrases too. His parents were terrified of what was going to happen to his brain as he got older but the psychiatrist they worked with was convinced this child needed these two medications. The parents said they didn’t want him on it, but they didn’t know what else to do.
They didn’t know what else to do.
Well, I could think of one thing they could do. One thing that’s pretty damn obvious, I think. You probably can too.
And don’t worry, the behavior they described wasn’t even close to actual Bipolar Disorder.
We’re a quick-fix country. And we instill that ideal in our children. Native cultures teach you to think about what you’re doing in terms of the generations before you and the generations ahead of you. How do you think our children will be five, seven generations later? Popping a pill for the cut on their knee?