Why won't a psychiatrist diagnose me?

[lilly090]

Im 19 years old and over the last 10 or more years ive always struggled with my mental health. Ive been diagnosed with adhd , odd and borderline traits. Over the last 10 years ive been showing strong signs of anxiety and depression espically SAD. I have went to multiple doctors and psychs , got bloods checked and health examinations done and yet when i ask the question " do i have depression?" Its always a straight up answer of "NO"... The signs and symptoms ARE THERE ! But yet everyone i have been to see always either says "no" or they say " we might never know"  not once has anyone ever properly listened to my symptoms and how i feel etc they dont even take a second to consider it...  Its really frustrating me and i feel like im broken and i cant be helped.  I dont understand why no one will even look into it for me?

[specialmom]

I find it pretty amazing you had a suicide overdose but you aren't diagnosed with depression. What was the trigger for the suicide attempt?

[lilly090]

It was a really low mood anxiety and bad mood swings and stress that was building uo for months before hand and my bf broke up with me and that set me over the edge so it was all focused on way i can cope

[specialmom]

I'm really sorry hon.  Is the psychiatrist able to get you in sooner?  I know you finally got an appointment and now it is almost Nov. So it won't be long until you can see him/her.  But if they could get you in sooner, that would be fantastic!

[lilly090]

I told them on the phone 2 weeks ago that it was an emergency and end of november was what they gave me  there be no way i could get one sooner

[specialmom]

I'm sorry to hear about the OD.  The thing that is maddening is that your doctor doesn't get that if you OD'd you were likely self medicating.  Addiction is so tied to self medicating for underlying mental health problems.  Not calling you an addict but the OD'ing part means you were using. What did you OD on?
It stinks your doctor has put off seeing you until later in November.  Make a full list of what you NEED him to know so that you can get adequate care.  It sounds like your system has had a lot of red tape and they messed a few things up in your situation.
Interesting that they are testing you for sensory.  It can be very overwhelming for people if they have sensory integration issues and aren't aware to do any coping strategies to deal with it.  It causes immense anxiety in my son.  It affects him in a lot of ways.  And sensory integration disorder is adhd's cousin. Both neurological in nature and have some similar components.  People can have both at the same time too.  Sensory isn't something you take medication for though.  You know what helps regular sensory symptoms?  What OT's call 'heavy work' which is deep pressure of the muscles and muscle work.  Carrying something heavy, pulling on limbs, swinging, lifting weights, doing push ups or wall push ups, etc.  I have a long list of things that help my son tremendously. But he also has coping strategies to deal too when he is unregulated.  
Anyway, again, we are here to listen and to help sweetie!

[lilly090]

I took an od on paracetamol, i dont and never have used and drugs before

[specialmom]

Oh gosh.  You were trying to kill yourself or was it accidental?  Sorry for the questions.  I just don't know how they couldn't diagnose you as suicidal if you had a suicide attempt!  That's outrageous.

[specialmom]

Sorry.  That should read diagnose you as Depressed if you had a suicide attempt! typo

[lilly090]

It was a suicide attempt

[Paxiled]

You know, we're not there.  We only know what you say.  But if you are reporting this all the way it happened, leaving nothing out, it's impossible to not diagnose someone who tried to commit suicide as not being depressed, at least at the moment you tried it.  People have all kinds of reasons for committing suicide.  Some of them are pretty good ones -- people at the end of their lives suffering from end stage diseases.  People suffering from incurable diseases who have exhausted all options of treatment.   But you're only 19 and you don't have those things, so again, obviously you're suffering from depression or you wouldn't have tried to kill yourself.  I know you've reported a long list of professionals you've consulted, but if this is all true and nothing has been left out and nothing has been confusing to you about what has been diagnosed, it's impossible to believe this could happen.  So if it did, you have been royally screwed.  Clearly you need desperately to find a competent and caring professional to treat you, because this isn't ADHD behavior.  I hope you find real help.

[lilly090]

For them its all about finding ways to "cope" but cope from what? They won't tell me and they dont even think about what could be making me feel this way, at the end of the day they put it down to "mood swings"

[AnxiousNoMore]

I think you need to continue with the psychiatrist, because when you make claims like "they won't tell me" then there is some kind of communication problem on either your end or the psychiatrist's end that won't get solved from here.

[lilly090]

You see i wait over an hour for my app even tho its at a set time and i dont even get 10 mins with him , because if i ask for anyone more time or try to keep him any longer he blows me off saying hes got other patients  to see

[Paxiled]

Here's the thing -- psychiatrist today generally don't do therapy.  Some still do, but most are just drug consultants.  They tend to spend a bit of time with you on the first visit, but after that, the drug consult is only 15 minutes.  If you're seeing someone who takes insurance, that will be even more so, as that is all insurance pays for.  But if you feel you need a longer visit, you can choose to pay for one.  You ask your psychiatrist for a half hour visit.  You can even ask for a full 45 minute hour, which is what an hour is to a psychiatrist, but it will be expensive.  The person you talk to if you need more than that is a psychologist, not a psychiatrist.  The system has become bifurcated between the two professions.  A lot of the reason is that a psychiatrist can make a lot more money and see a lot more patients every day just dispensing meds -- as you see, they don't spend much time with patients.  Because psychologists charge less, most people have turned to them for therapy, and frankly, they study a lot more psychology than a psychiatrist does.  In fact, most psychiatrists get a short course in psychology from a psychologist who teaches at a medical school; otherwise they are trained physicians who choose to specialize in psychiatry.  There was a time when psychiatrists did a lot of therapy, and there are still those who do, but this is just how it has evolved.  So again, if you feel you need more time with your psychiatrist, you have to schedule for a longer appointment in advance, but you will also have to pay more for it if you're not on insurance -- most mental health practitioners don't take insurance at all, and in my experience, the best ones don't.  This is especially true if you live in an urban area with a lot of people who earn a high salary, giving them lots of patients who can pay.  These short appointments are one of the reasons so many psychiatrists don't like insurance -- they are really limited in how much time they get paid for.  One way to deal with this is to prepare before you go to your appointment -- write down all the questions you want answered in advance.  For the real talking, though, a psychologist will be better.  But you say they are pointing to mood swings.  That could actually be a diagnosis that indicates they think you are bipolar.  I have no idea if you are or not, and a lot of people these days are diagnosed with versions of bipolar that are really just the way they manifest their depression.  But when they say the key is finding ways to cope, that is actually the right answer.  No matter what the diagnosis would be, the fix is learning to cope with it.  Sometimes this requires medications.  Sometimes just therapy.  Sometimes both.  But that is how those who do get better do it, by learning ways to cope and alter the thinking that makes them miserable.  It doesn't really matter if you have to cope from depression or anxiety or depression with mood swings, you still have to learn coping techniques.  That part is true.

[Paxiled]

And if you have to wait an hour for a scheduled appointment, you need to find a different psychiatrist.  Seriously.

[lilly090]

Ive private insurance and always been private but i cant get into the private clinic i want to get into as my doctor while i was in patient messed things up big time for me and sent me public for an assesmemt i didnt even need and right now ive nothing till the end of november

[Paxiled]

Don't really understand this last comment.  Private insurance is better than public insurance usually, if by public you mean gov't programs such as Medicare.  If you have good insurance, it will often offer options that include a larger number of practitioners.  But if you have poor private insurance, and this is true for most Americans, then the networks of providers will be very small.  But your comment that you have private insurance but your inpatients psychiatrist sent you public, not sure what that means.  If you have insurance of your own, you get to do anything the plan covers.  Whatever is going on, it just looks like what you need isn't a clinic, whatever that is, but a good psychiatrist no matter where he or she works, be that in a clinic or in an office that just has a desk and a computer.  The quality of the doc is what is most important.  

[lilly090]

My psych inhospital sent me public which really annoyed me because he wanted them to carry out a forensic assessment on me and that the private clinic couldnt do it , turns out now i dont need it so im trying to get my gp to refer me back to the private clinic. Btw i live in ireland , and we dont have poor insurance, i have a full time job so does my parents , were actually quiet wealthy thank god

[Paxiled]

If that's the case, then find the best psychiatrist available.  The best psychologist.  You can pay for it.  Ireland, I'm assuming, has socialized medicine, as virtually every country but the US has it.  Are you anywhere near a university with a psychiatry program?  Those professors will usually also have private practices, and if Ireland's system is like other European systems there is a mix of private and socialized medicine.  Is that true?  If it is, find the best and get this problem diagnosed once and for all.  Wealthy people can always find help.

[specialmom]

Boy, you've been through the ringer.  And it sounds like you were let down by the mental health system.  What was the reason for entering the psych hospital if not depression?  Was it a public hospital?   Very strange that they had you there, had you undergo therapy and yet are not diagnosing you with depression.

My son did occupational therapy for six years and it was helpful for him but not sure if it is appropriate for what you deal with.  He found himself very overwhelmed by his environment and like his insides were just chaotic in that he could not sit still, couldn't think clearly, etc.  Occupational therapy for him taught him coping mechanisms and exercises to make it better.  But he has sensory issues and you might not.  Does seem like an odd specialty for you to be seeing given all of the things you have been through.  

Hold old are you if you don't mind me asking?  Have you ever been to strictly a psychiatrist that is in private practice?  I am assuming you have but just wanted to confirm.  It's difficult to do much if your medical team is not being helpful or cooperative.  I really feel for you.  

[lilly090]

Was admitted due to a serious OD.  It was a private hospital , i was put on an intense dbt course which looked at emotions and ways to cope and not make it worse it was called living through distress. When i was discharged this march he referred me to my local public mh team and i wasnt happy as i had referral a referral sent to their private op clinic and they refused it as i was to get a forensic assessment. That was in march. It os now october and i just found out i dont need to get a forensic assesmemt as there was no charges given and ive only seen this new psychiatrist twice since march... when i last saw him 3 weeks ago he didnt say anything , looked at my file and said " ill see you in 4 months time" which is jan 2019... i came out crying so bad as i wasnt able to cope that long without a psychiatrist. I then called him last week asking for a sooner app as i was in crisis and he game me one for the end of november which isnt very good...  also i saw my ot on monday and she did a sensory test ( i dont know why ) and i will see her november the 13th with the answers from it. Im also just gone 19 in August

[Paxiled]

I have to say, it does sound like bipolar, though I am not a psychiatrist and am not qualified to make that diagnosis.  But boy, you do fit, don't you?  The depths of depression and the highs of mania.  You know, manic episodes don't have to be all out craziness, and the depression doesn't have to be suicidal.  It does vary with the person.  My own investigations, for what they're worth, match your experience, which is, most mental hospitals are just warehouses and when they run out of beds they evict you.  The very rich can get to better facilities, but for the rest of us, it's not always the best place.  I would expect a better answer to your questions, though -- you seem to be very actively trying to reason this out and it's horrible that the professionals aren't giving you some kind of answer.  On the other hand, you have been on some meds that would deal with that problem.  But it is trial and error, there is no accurate test that tells you what med works best or what mental illness you have or whether you have one.  What I said about the thyroid is true, though, almost universally doctors test for something called TsH, which is a pituitary gland test.  They don't test for free T3 and T4, and how well they convert to one another, which is the only way to accurately diagnose a thyroid problem.  But I have to say, the symptoms you're describing aren't necessarily thyroid ones, and with a bad thyroid you wouldn't have those manic episodes.   If you truly are bipolar, that speed you're taking for ADHD is not the right thing.  If you're truly bipolar, only medication can treat that condition, therapy can help you learn to cope but it can't fix that one.  I like very much what Mom asked, which is, have you ever gotten a referral to a really good psychiatrist on an outpatient basis?  They are most versed in treating this.  A good psychologist should also be able to diagnose bipolar.  It's a hard illness to treat, if you have it -- if you don't have it, the meds for it can have a lot of side effects that aren't worth it.  You've seen so many docs, sometimes we fall through the cracks of what is known.  I'm in that boat -- I suffered a withdrawal from stopping a med, got bad treatment for it (denial, actually) and have never recovered.  What I have has no known treatment.  It is rare.  Maybe you're in that rare boat.  Life is rough.  But you have to keep trying to find answers.  You're right, the ones you've gotten don't sound like what psychiatrists sound like and I've seen a bunch of them.  Keep searching.    

[Paxiled]

Well, one amendment.  If you were hyperthyroid, you might feel like you were manic, but you might feel that way all the time, not just sometimes.  But you would also eventually burn out your thyroid and your adrenal glands and end up fatigued all the time.

[lilly090]

Sometimes i wonder if i am bipolar as when i wasnin hospital there was a girl with bipolar 2 and she even said it herself that the way i was acting not sleeping talkinv etc was like someone who was bipolar but then my gp says im not bipolar amd everyone else so i just dont know , ive asked all the questions and still get no answers apart from " no" or " we might never know"

[Paxiled]

First, the emotional problems of a 9 year old aren't the equivalent of adult depression.  If you had ADHD -- and I say if because this is a very controversial subject in mental health, being way overdiagnosed -- but the ODD goes along with it.  Did you get treatment for these things when you were 9?  Did it work?  You also say borderline traits, but you don't explain which borderline traits.  That term can mean different things, but it usually refers to having, say, symptoms that are similar to bipolar without being bipolar.  But you don't say, so we can't know.  You've seen lots of the specialists who know depression when they see it, and they haven't seen it.  If you'd only seen one, well, most of them are like anyone else, not that great at what they do, but if you've seen several, well, that's a lot of agreement.  SAD is pretty easy to diagnose, because it only occurs in the winter generally.  Are only sad when it's dark out?  Now, no blood check can tell you a whole lot if the doc isn't looking for a whole lot -- thyroid problems, for example, are almost never properly checked by docs, they don't look for the right things.  But you say you've told they might never know if you have depression or anxiety, and if you've been told that, that part of it is nonsense.  Just because you have ADHD doesn't mean you don't also suffer from anxiety or depression or both.  You know you have it because it you feel sad all the time or you think anxious thoughts much of the time and avoid things.  It's a disease of thinking.  If it lasts a long time, you have it.  The question of the cause is a tougher thing to handle -- again, lots of physiological problems can cause anxiety and depression.  You have been diagnosed with two conditions you've listed that can lead to getting anxiety and depression if they are not successfully treated.  So let me ask you, what have you tried so far to beat this?  What treatment have your doctors tried?  Without knowing that, it's very hard for anyone on here to know what's happened and where you might go next.

[lilly090]

Ive had 3 hospital admissions last year , i got diagnoised with adhd when i was 15 and again when i was 16 after moving to a new school ,  with the bpd traits , i have sereve mood swings , extreme fear of abandonment, impulsive behavior, self destructive behavior no sense of self or identity, extreme anger and feeling empty alot,  i was 17 when my old mh team told me about it but said i couldnt be diagnoised until i was over 18.  When i was 14 i was seeing a psychologist to do with my adoption and he ruled out ptsd with severe anxiety but that was never mentioned ever again by anyone else afterwards.  I spent 6 months in a psych hospital and the signs of depression was clearly there but the doctor i had there was useless , he caused more damage for me then good , i asked him at one stage " do i have depression?" He said no i asked again do i have SAD?" And before i even finished the question he said no.. Its really frustrating because I know theres something there but when i try talk about it no one listens to me or even thinks about it , its always the same amswers "no" or " we might never know"..  ive had cbt , dbt , play therapy , art therapy , group therapy addiction counseling, you name it ive had it all apart from ect... currently seeing an OT whoch to me is pointless because shes always talking about finding my own path in life but how can i find it if i dont know where to start from?   Ive seen atleast 20 different doctors nurses and therapists over the years and when i wasnwith the mh team as a teenager ( under 18) my gp was actively involved with blood tests being done , my tyroids was checked regularly and all and there was no physical signs that was causing my mood to be they way it is... i get long periods of "depression " ( typically 6 months atleast ) where i just ignore everything , i have 2 horses i love but i cant bring myself to even look at them anymore...   im constantly exhausted and constantly over sleeping or i go 2 days with no sleep due to being taken off my sleeping meds and they wouldnt put me back on them.. but then im not sure if its my adhd or what it is , i get a period or a week or two where im completely opposite of depression where i can function on little or no sleep , im extremely active im hyped up its like one massive sugar rush that lasts for a week or two then it drops again back to the very low mood and it goes like that alot but the hyped up mood isnt as often as i would like. Being hyped up like this is great but it causes alot of problems for me because even tho i feel exhausted im still running around non stop, and i get really irratated and agrivated from it, my parents always asume im on drugs when this happens but i dont take drugs and ive been tested recently and passed it when i saw my gp.

[lilly090]

When i was in school i was also put on meds for my adhd which helped things abit but my mood still dropped and my highs were still there , then once i finished school, i was put on risperadol , serequol , abilify , prozac and lexapro   Over a 3 year period it really was trial and error.