Newly diagnosed by psychiatrist, psyd disagrees

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    • #114221
      mightyconcorde
      Participant

      What to do? I see the PsyD every two weeks for therapy. I have an 8 year relationship with him, but he disagrees with my C-PTSD diagnosis from inpatient treatment and he disagrees with my Psychiatrist’s ADHD diagnosis. PsyD feels it all falls under my major depression. What to do?

    • #114228
      jkate23
      Participant

      How do YOU feel about the diagnosis? You know yourself better than anyone, so I would trust in yourself and your feelings on the matter.

      Many people go undiagnosed all their lives, and often misdiagnosed due to comorbid conditions. It is possible that you have ADHD, PTSD and depression. If the depression is what your PsyD has been purely focusing on then perhaps he is missing the big picture.

      I’ve been on antidepressants for years, I’ve been on a combination of two, which is jokingly referred to by psychiatrists as ‘Californian rocket fuel’. My Psychiatrist that diagnosed me for ADHD was quite surprised at the dosage of one of them, as it was a very high dose. And for all of that, I was always feeling below average, just getting by. I was beginning to think that I was treatment resistant. Now I realise that it was untreated ADHD.

      Do you mind me asking if you have been taking any medications for the last 8 years for depression? If so, how much do you feel it has helped? Also, regarding your PsyD, I understand therapy can often be incredibly beneficial as an ongoing, lifelong process. My most recent therapist was fantastic, and I probably should still be seeing her, as she taught me so many things about life that I somehow completely missed! Over eight years with him, how do you feel he has helped you? Do you feel like he has made great change over the period or is there something that you feel still just isn’t right. Something that just feels like it hasn’t been addressed? If that is the case, I would open your mind to other conditions which may be underlying ie the inpatient Psychiatrist may well be spot on. My massive doses of antidepressants and sporadic therapy over the years never fully worked as they were treating only half of the problem.

      Also, how much experience does your PsyD have with ADHD? Mine, bless her, had a working knowledge, enough to agree with my diagnosis, but she ended up asking me a bunch of questions about the medication and condition – do I just take it when studying etc, what difference does it make, how long can I actually focus for without it etc. She is a clinical psychologist as well which is the equivalent to the PsyD. This told me although she knew the defining characteristic about it, she didn’t fully understand how the condition affects people on a day to day basis. All of the traits that are less talked about, or don’t fit neatly in the diagnostic criteria, she didn’t know so much about. But she wasn’t trained to do that, her role is much different than that of a Psychiatrist.A Psychiatrist has studied more extensively than a Psychologist and a Psychiatrist will understand the physiological causes and complexities of the condition much better. I don’t mean to undermine a Psychologists role by any means, they have an invaluable part to play in treatments for mental health where psychiatrists and medications can fall short, but I would be more inclined to trust the evaluation of a Psych on these grounds.

      Have you started on ADHD meds? If so have you found them to be helpful? How do you feel when you read about ADHD in adults? Do you feel ‘that’s me!’ When you read about it? Also bear in mind that ADHD can manifest a bit differently depending on subtype etc. Myself, and some other adult members of my family have all been diagnosed fairly recently. It is interesting to note how different we are and the level to which it is noticeable. Undiagnosed ADHD can be very difficult to detect for an outsider if that person has learned how to mask their difficulties well. This certainly does not mean that this person is really functioning well internally.

      I hope this helps!

    • #114237
      Outsider
      Participant

      Keep in mind that you are the world’s foremost expert in you!
      Diagnosis is less important than your treatment success. If you agree with the psychiatrist on diagnosis but still have a good relationship with the PsyD, then work through your situations without regard of diagnosis. Diagnosis is just a label so a treatment approach can be started. Work with both docs and continue to be the expert on you and find what works for you, not what others think you need. Be clear with both docs on what works and doesn’t. If that puts a strain on your relationship with either the psychiatrist or psychologist, then you should find a new one.

    • #114291
      Dr. Eric
      Participant

      Ask each one at least 20 questions as to their rationale.
      The one who answers your questions in reasonably plain English with patience the best is my vote.

    • #114330
      mightyconcorde
      Participant

      Hi, Thanks for the responses. jkate23: I do agree with both diagnoses. I definitely have depression. I have been concerned about being treatresistant as well! I have been on meds for the depression for all 8 years, and they have helped a bit, but i hit a major bump two years ago and was hospitalized 5 times for suicidal thoughts. I am beyond that now, but all along, with therapy and meds, i still have felt we weren’t getting to the root, you know? Something… we were missing something. He wasn’t addressing the trauma, we simply talked about the events whenever i brought them up. I know i need trauma therapy. When my ADHD daughter recently suggested that i ought to look into it myself, i started reading and was floored! Spoke with psychiatrist who started me on Adderall right away. I have been devouring ADHD books from the library. I haven’t been able to read a book in over 5 years… no focus. PsyD says depression. Could be right. He is a clinical psychologist as well, so his leaning is toward testing, but he does have the private practice and is a very down to earth person. Since the Adderall, i have also been able to pick up a phone and call a lawyer about my husband’s estate. Something i should have been addressing since last July! But, you know…

    • #114338
      jkate23
      Participant

      I’m glad to hear that things have been better for you recently, and I’m glad to hear that the Adderall is helping! ADHD runs pretty strongly in families, as I’m sure you have read about!

      It might be a good idea to look at finding a Psychologist who could help you a bit better considering your recent diagnoses? Finding the right person who has a solid understanding of the things you are trying to work through, and who you feel you have a connection with is so important. If that level of understanding isn’t there, it can be hard to make progress. It might be worth looking into at any rate 🙂

    • #114352
      mightyconcorde
      Participant

      My psychiatrist and I have been discussing that idea. I don’t want to give up on him yet! Today’s appt I managed to tell him that I felt I had nothing more to say to him. After much silence, he asked comparing our relationship to another in my life and he asked if i felt he and i were going sour. His word, not mine. I don’t remember (!) exactly what i said, but it was a no and we got to how would i like therapy to proceed. After a bit of silent deliberation, i came up with this: “we are going to talk about adhd. You don’t know me. I am always on time for you. But… and i proceeded to tell him a story of a typical time “trying” to get to a friends house. So i am going to swing you over to our team. You don’t know me. I have adhd” He laughed of course at the team comment.
      Yes, we have been together therapeutically for 8 years, but it’s been fairly existential purging on my part and probing on his part. I don’t go in there and talk about my week. Unless there is something big happening. I believe i have strayed.

    • #114353
      mightyconcorde
      Participant

      So, a bit of a breakthrough… he is good with it.

    • #114410
      jkate23
      Participant

      That’s good, glad to hear that he has been more receptive! This is your journey and the number 1 priority is that you get the support and guidance in the areas that you need! Don’t be afraid to back up your own thoughts and instincts, as you are your own champion sometimes :). I hope that this is the beginning of a better, more productive relationship there!

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