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Does seeing a patient twice in four days meet any DSM criteria


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Not one to start threads.

But i'd like to know an answer to this above title question.  So thought id go to the audience on this one.

Basically im in an argument with the med prof.

My understanding is for a diagnosis of depression to be made say the doctor has to see you over a 2 week period . That is the first criteria that must be met right? If not then such a conclusion is invalidated right.

 

A conclusion cannot be made from seeing a patient twice in 4 days right? And no criteria checklist even completed right?

Appreciate any replies on this.

Thought for the day: Lets stand up, and let’s speak out , together. G Olsen

We have until the 14th. Feb 2018. 

URGENT REQUEST Please consider submitting  for the petition on Prescribed Drug Dependence and Withdrawal currently awaiting its third consideration at the Scottish Parliament. You don't even have to be from Scotland. By clicking on the link below you can read some of the previous submissions but be warned many of them are quite harrowing.

http://www.parliament.scot/GettingInvolved/Petitions/PE01651   

Please tell them about your problems taking and withdrawing from antidepressants and/or benzos.

Send by email to petitions@parliament.scot and quote PE01651 in the subject heading. Keep to a maximum of 3 sides of A4 and you can't name for legal reasons any doctor you have consulted. Tell them if you wish to remain anonymous. We need the numbers to help convince the committee members we are not isolated cases. You have until mid February. Thank you

Recovering paxil addict

None of the published articles shed light on what ssri's ... actually do or what their hazards might be. Healy 2013. 

This is so true, with anything you get on these drugs, dependance, tapering, withdrawal symptoms, side effects, just silent. And if there is something mentioned then their is a serious disconnect between what is said and reality! 

  "Every time I read of a multi-person shooting, I always presume that person had just started a SSRI or had just stopped."  Dr Mosher. Me too! 

Over two decades later, the number of antidepressant prescriptions a year is slightly more than the number of people in the Western world. Most (nine out of 10) prescriptions are for patients who faced difficulties on stopping, equating to about a tenth of the population. These patients are often advised to continue treatment because their difficulties indicate they need ongoing treatment, just as a person with diabetes needs insulin. Healy 2015

I believe the ssri era will soon stand as one of the most shameful in the history of medicine. Healy 2015

Let people help people ... in a natural, kind, non-addictive (and non-big pharma) way. J Broadley 2017

 

 

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I haven't heard that Mark.  I know that low mood has to be present for at least a 2 week period - together with anhedonia and other symptoms but I don't know about any requirement in the DSM for how often the Dr needs to see the patient before making a diagnosis.  TBH many doctors don't even 'diagnose' according to the criteria given.

Personal history of GAD and 4 melancholic depressive episodes - two treated with Amityptline

Family history of Bipolar Disorder - goes back at least 3 generations

Adult son with autism, ADHD, intellectual disability and Bipolar II

Put on Aropax / Paxil in July 1997 for anther episode.  Decision to stay on it - worst decision of my life.

Began to poop out in late 2008. Switched to Lexapro March 2009.  Made me suicidal.  Tried Cymbalta for 19 days. Horrible w/d.

Found PP and RI'd Aropax at about the same time - August 2009.  Began slow taper in 2010. Crashed in 13-11mg range in mid 2013.  Switched to Citalopram 21 Oct 2013 in an attempt to stabilise.

 

There are things that are known, and things that are unknown; in between are doors - Anonymous

 

https://itunes.apple.com/au/book/longing-for-life/id958423649  My book about my unsuccessful journey through IVF

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Haven't heard of it Mark. When I was diagnosed (long long ago) it was just the one visit....

Put on Prothiaden for severe depression in 1989.  Recovered.   Prescribed Paxil for another bout of depression around 2000.   Have been trying to taper ever since but always crash about 2 months after getting to zero.   Because of the crashes, for years I thought that there was something wrong with me.   Then found that the crashes were simply withdrawal.   Now following a maximum of a 10% reduction every month or so and ready to slow down any time I feel any symptoms whatsoever.  Feeling good:).

7th Jan 15 - 3.6mg

28th Jan 15 - 3.2mg

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  • Moderator Emeritus

I can't say from an accepted medical standpoint of how medicine is practiced.  However, as an academic researcher and former college professor (albeit in other fields), I would say that any conclusion made based only on a one- or two-time observation risks being a sloppy conclusion.

The whole medical field is excessively primitive, though.  The ******* doctors are just guessing at everything and we are their guinea pigs.  For example, you could have a case where one visit is enough to diagnose a sinus infection, based on fever and other symptoms present.  However, what about a complex case where a more serious illness is MIMICKING a sinus infection?  The second scenario requires more than one visit, but the time delay between visit one and visit two puts the patient at risk.  Because of that risk and because more serious diagnoses are considered rare, medicine now seems to be practiced in a way where doctors are pressured and rushed to make their diagnosis IMMEDIATELY.  What's worse, if we expect them to be more careful and take more time with their diagnosis, or if we question the diagnosis at all, they get resentful.

 

Your professor sounds like a moron, frankly.  He or she should at least be teaching students to consider MANY possibilities for diagnosis and to strive for the CORRECT diagnosis, not the fast one.  Obviously, for the safety of patients, diagnoses do need to be made as quickly as possible, but not at the expense of correctness.

 

Additionally, why would any doctor NOT use a criteria checklist?  A criteria checklist should be part of ANY diagnosis made of any medical condition, and I'm appalled to find out that's not how students are being taught.

 

Again, I'm no medical researcher, but I can tell you for a fact that this kind of sloppiness would never fly in my field, and I have no hope for the future of medicine or the safety of patients if this is how sloppily medical students are being taught.

Here is what the Mayo Clinic says about how the American Psychological Association diagnoses depression using DSM criteria (more than two weeks, by the way):

http://www.mayoclinic.org/diseases-conditions/depression/basics/tests-diagnosis/con-20032977 

 

Lastly, I think we should all be aware that even if someone DOES have symptoms for over a two-week period, that doesn't mean they suffer major depressive disorder or should be treated with drugs.  What if their child died tragically?  Or their mom, dad, or spouse?  What if they found out their significant other was having an affair?  For God's sake, ANY of those things could put someone into a lengthy depression, but still a temporary or manageable depression if it is a person with no history of mental health problems.  Life is HARD and everyone suffers at least one major depressive episode, but that does not mean that a depressive disorder diagnosis is accurate for every case of depression lasting for over two weeks.

 

NO WONDER people are being POISONED with unnecessary medications if this is how irresponsibly med profs are disseminating information. 

*I'm not a doctor and don't give medical advice, just personal experience
**Off all meds since Nov. 2014. Mentally & emotionally recovered; physically not
-Dual cold turkeys off TCA & Ativan in Oct 2014. Prescribed from 2011-2014

-All meds were Rxed off-label for an autoimmune illness.  It was a MISDIAGNOSIS, but I did not find out until AFTER meds caused damage.  All med tapers/cold turkeys directed by doctors 

-Nortriptyline May 2012 - Dec 2013. Cold turkey off nortrip & cold switched to desipramine

-Desipramine Jan 2014 - Oct. 29, 2014 (rapid taper/cold turkey)

-Lorazepam 1 mg per night during 2011
-Lorazepam 1 mg per month in 2012 (or less)

-Lorazepam on & off, Dec 2013 through Aug 2014. Didn't exceed 3x a week

-Lorazepam again in Oct. 2014 to help get off of desipramine. Last dose lzpam was 1 mg, Nov. 2, 2014. Immediate paradoxical reactions to benzos after stopping TCAs 

-First muscle/dystonia side effects started on nortriptyline, but docs too stupid to figure it out. On desipramine, muscle tremors & rigidity worsened

-Two weeks after I got off all meds, I developed full-blown TD.  Tardive dystonia, dyskinesia, myoclonic jerks ALL over body, ribcage wiggles, facial tics, twitching tongue & fingers, tremors/twitches of arms, legs, cognitive impairment, throat muscles semi-paralyzed & unable to swallow solid food, brain zaps, ears ring, dizzy, everything looks too far away, insomnia, numbness & electric shocks everywhere when I try to fall asleep, jerk awake from sleep with big, gasping breaths, wake with terrors & tremors, severely depressed.  NO HISTORY OF DEPRESSION, EVER. Meds CREATED it.

-Month 7: hair falling out; no vision improvement; still tardive dystonia; facial & tongue tics returned
-Month 8: back to acute, incl. Grand Mal seizure-like episodes. New mental torment, PGAD, worse insomnia
-Month 9: tardive dystonia worse, dyskinesia returned. Unable to breathe well due to dystonia in stomach, chest, throat
-Month 13: Back to acute, brain zaps back, developed eczema & stomach problems. Left leg no longer works right due to dystonia, meaning both legs now damaged
-7 years off: Huge improvements, incl. improved dystonia

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Thanks for the replies people.

Wiggleit im not referring to a professor im referring to the medical profession. ie doctors. Sorry for the confusion.But yes you are right they are just idiots. Yes i totally agree with what you are saying people are being pushed into druggery by uninformed consent for just stupid reasons ...they have as they say medicalized normality.

 

Junior thats right a 2 week period must exist within which specific symptoms  must exist. But to have a doctor just ignore it and do whatever...peddle drugs for whatever xyz reason is just unacceptable b/c how can they justify it. They are just making up defns. for petes sake . If not diagnosing on the criteria given then how does this stand up in court ...are doctors cowboys that can act with impunity and get away with it. Its disgraceful!

 

Ever thats terrible.!

 

Thanks for the replies.

Thought for the day: Lets stand up, and let’s speak out , together. G Olsen

We have until the 14th. Feb 2018. 

URGENT REQUEST Please consider submitting  for the petition on Prescribed Drug Dependence and Withdrawal currently awaiting its third consideration at the Scottish Parliament. You don't even have to be from Scotland. By clicking on the link below you can read some of the previous submissions but be warned many of them are quite harrowing.

http://www.parliament.scot/GettingInvolved/Petitions/PE01651   

Please tell them about your problems taking and withdrawing from antidepressants and/or benzos.

Send by email to petitions@parliament.scot and quote PE01651 in the subject heading. Keep to a maximum of 3 sides of A4 and you can't name for legal reasons any doctor you have consulted. Tell them if you wish to remain anonymous. We need the numbers to help convince the committee members we are not isolated cases. You have until mid February. Thank you

Recovering paxil addict

None of the published articles shed light on what ssri's ... actually do or what their hazards might be. Healy 2013. 

This is so true, with anything you get on these drugs, dependance, tapering, withdrawal symptoms, side effects, just silent. And if there is something mentioned then their is a serious disconnect between what is said and reality! 

  "Every time I read of a multi-person shooting, I always presume that person had just started a SSRI or had just stopped."  Dr Mosher. Me too! 

Over two decades later, the number of antidepressant prescriptions a year is slightly more than the number of people in the Western world. Most (nine out of 10) prescriptions are for patients who faced difficulties on stopping, equating to about a tenth of the population. These patients are often advised to continue treatment because their difficulties indicate they need ongoing treatment, just as a person with diabetes needs insulin. Healy 2015

I believe the ssri era will soon stand as one of the most shameful in the history of medicine. Healy 2015

Let people help people ... in a natural, kind, non-addictive (and non-big pharma) way. J Broadley 2017

 

 

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Lord knows how it would stand up in court.  Interesting thought.  But then I understand that the DSM and even the ICD-10 or whatever edition we are up to are just 'guides'.  If I remember correctly, the DSM originally came into being to give some uniformity to the diagnoses psychiatrists were making.  People could go to 3 different psychs and get three different labels!

 

Personally I think the only ones who should be diagnosing and treating mental health conditions are those properly qualified to do so - clinical psychologists and psychiatrists - but then we all know what happens with the latter, don't we?  It's also astounding how psychiatry has moved from predominantly practising psychoanalysis to reducing people to biological objects.

Personal history of GAD and 4 melancholic depressive episodes - two treated with Amityptline

Family history of Bipolar Disorder - goes back at least 3 generations

Adult son with autism, ADHD, intellectual disability and Bipolar II

Put on Aropax / Paxil in July 1997 for anther episode.  Decision to stay on it - worst decision of my life.

Began to poop out in late 2008. Switched to Lexapro March 2009.  Made me suicidal.  Tried Cymbalta for 19 days. Horrible w/d.

Found PP and RI'd Aropax at about the same time - August 2009.  Began slow taper in 2010. Crashed in 13-11mg range in mid 2013.  Switched to Citalopram 21 Oct 2013 in an attempt to stabilise.

 

There are things that are known, and things that are unknown; in between are doors - Anonymous

 

https://itunes.apple.com/au/book/longing-for-life/id958423649  My book about my unsuccessful journey through IVF

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  • Moderator Emeritus

Ha!!!!  I totally assumed that "med prof" was short for a medical professor and that you were taking some kind of psychology class!

 

Well, THAT makes my former reply totally off the mark!  Oops!  I still stand by what I wrote, but a lot of might make more sense in a different context. :P

*I'm not a doctor and don't give medical advice, just personal experience
**Off all meds since Nov. 2014. Mentally & emotionally recovered; physically not
-Dual cold turkeys off TCA & Ativan in Oct 2014. Prescribed from 2011-2014

-All meds were Rxed off-label for an autoimmune illness.  It was a MISDIAGNOSIS, but I did not find out until AFTER meds caused damage.  All med tapers/cold turkeys directed by doctors 

-Nortriptyline May 2012 - Dec 2013. Cold turkey off nortrip & cold switched to desipramine

-Desipramine Jan 2014 - Oct. 29, 2014 (rapid taper/cold turkey)

-Lorazepam 1 mg per night during 2011
-Lorazepam 1 mg per month in 2012 (or less)

-Lorazepam on & off, Dec 2013 through Aug 2014. Didn't exceed 3x a week

-Lorazepam again in Oct. 2014 to help get off of desipramine. Last dose lzpam was 1 mg, Nov. 2, 2014. Immediate paradoxical reactions to benzos after stopping TCAs 

-First muscle/dystonia side effects started on nortriptyline, but docs too stupid to figure it out. On desipramine, muscle tremors & rigidity worsened

-Two weeks after I got off all meds, I developed full-blown TD.  Tardive dystonia, dyskinesia, myoclonic jerks ALL over body, ribcage wiggles, facial tics, twitching tongue & fingers, tremors/twitches of arms, legs, cognitive impairment, throat muscles semi-paralyzed & unable to swallow solid food, brain zaps, ears ring, dizzy, everything looks too far away, insomnia, numbness & electric shocks everywhere when I try to fall asleep, jerk awake from sleep with big, gasping breaths, wake with terrors & tremors, severely depressed.  NO HISTORY OF DEPRESSION, EVER. Meds CREATED it.

-Month 7: hair falling out; no vision improvement; still tardive dystonia; facial & tongue tics returned
-Month 8: back to acute, incl. Grand Mal seizure-like episodes. New mental torment, PGAD, worse insomnia
-Month 9: tardive dystonia worse, dyskinesia returned. Unable to breathe well due to dystonia in stomach, chest, throat
-Month 13: Back to acute, brain zaps back, developed eczema & stomach problems. Left leg no longer works right due to dystonia, meaning both legs now damaged
-7 years off: Huge improvements, incl. improved dystonia

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