Previous mental illness diagnosis and other health problems

mental-illness-7

A couple of weeks ago I went to the doctor due to some problems with my sciatic nerve and some other mysterious nerve sensitivity in my hands, face and feet. Googling my symptoms indicated the possibility of nerve damage which gave me some anxiety and I thought possibly there was some treatment for my sciatic problem. The doctor wasn’t my regular one but another one since it was  a walk in clinic. I had initially intended to go to my regular doctor but she insisted that I go immediately to the clinic that day and that she didn’t have any time to see me. My understanding was that my mysterious nerve symptoms overlapped with a description of  someone having a stroke so I indulged her anxiety and went in the clinic that same day.

Once I got there however they treated me like the neurotic one and the doctor insisted in the end that I should go to a psychiatrist despite the fact that I have no insurance coverage for mental disorders. For some reason the male doctor fixated on my irritated hands which were slightly red and dry(possibly due in part to the sun). Judging by his thinking he seemed to think I had OCD and or possibly Lupus. The Lupus could have been due to admission of some joint pain and my previous diagnosis of depression. His impression of my sciatic nerve problem was that it wasn’t enough of a problem for him to treat it at all. I inquired about muscle relaxants (anti-anxiety meds) but he didn’t want to prescribe for some reason. The philosophy of this clinic seems to be that anti-anxiety meds should be prescribed by a psychiatrist.

I have had a similar experience before like this. I mentioned some mysterious nervous symptoms and was referred to a psychiatrist. It seems like when a doctor can’t find a suitable diagnosis they immediately try to label the person as unstable…not terribly logical but it apparently saves them from confronting their own ignorance. Admittedly, part of this problem could be due to an error in communication. Here is an excerpt from an article on the topic of mental health stigma.

From a public standpoint, stereotypes depicting people with mental illness as being dangerous, unpredictable, responsible for their illness, or generally incompetent can lead to active discrimination, such as excluding people with these conditions from employment and social or educational opportunities. In medical settings, negative stereotypes can make providers less likely to focus on the patient rather than the disease, endorse recovery as an outcome of care, or refer patients to needed consultations and follow-up services.

At this point, I still have problems with my sciatic nerve and can’t walk for more than 15 minutes or so without resting due to the pain in my lower leg. Additionally, I have unusual sensitivity in my hands and feet which makes typing at the moment somewhat unpleasant. I am quite sure my previous diagnosis of psychotic depression is giving this doctor an excuse to not take my symptoms seriously and I am not sure what to do about it. Stigma due to mental illness is frustrating and it can impact other health problems which aren’t taken seriously.

update: tests don’t confirm Lupus

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Psychosis increases risk of bipolar disorder

Danish researchers have identified characteristics in people with psychotic depression that predict an increased risk for conversion to bipolar disorder.

The researchers analyzed data from several Danish registries to identify conversion to bipolar disorder among Surreal-portrait-of-a-young-man-300x438patients with an initial diagnosis of unipolar psychotic depression between January 1995 and December 2007.

Among the 8588 patients included in the study, 609 were diagnosed with bipolar disorder (defined as a new diagnosis of hypomania, mania, mixed affective episode, or bipolar disorder) during follow-up, giving a conversion rate of 7.1%.

Comparison of patients who did and did not convert to bipolar disorder identified a range of differences, seven of which emerged as significant risk factors in multiple logistic regression analysis.

These were: younger age at onset of unipolar psychotic depression (adjusted odds ratio [AOR]=0.99 per year of increasing age); recurrent depression (AOR=1.02 per episode); living alone (AOR=1.29); receiving a disability pension (AOR=1.55); and the highest educational level being a technical education (AOR=1.55), short-cycle higher education (AOR=2.65), or medium-cycle higher education (AOR=1.75).

Further analysis of the impact of age at psychotic depression onset found that, compared with people aged 20 years or younger at onset, the AOR for bipolar disorder was 1.64 for those aged 20–29 years, 1.58 for age 30–39 years, 1.80 for age 40–49 years, 1.36 for age 50–59 years, 1.19 for age 60–69 years, 0.85 for age 70–79 years, and 0.40 for age 80 years or older.

The researchers said that in comparison to previous studies the risk was underestimated in this latest study. Interestingly people in the age group (40- 49) appear to have a greater risk than younger groups. I was under the impression for some time that bipolar disorder developed much earlier. Perhaps a greater fluctuation in hormones levels might increase the risk as well.

This study was of interest because I have experienced depression since age twelve and also experienced psychotic depression around age 14 and at 39. Despite experiencing some characteristics of bipolar disorder my doctors didn’t think bipolar disorder was likely.