Misdiagnosing bipolar disorder as a purely depressive disorder can have disastrous consequences, especially if prescribed antidepressants instead of mood stabilizers. [1]
Genetic testing for clotting. Autoimmune work up.
Spinal tap for pressure.
Make a list every symptom, and what affects your symptoms. Take it to every kind of specialist. Then keep repeating. Take an advocate. I would explain stuff, could see they had mentally written me off. The wife would start bawling. This would wake them up, and they would dig further.
A neuro-ophthalmologist was reading my list. Looked up and declared I had Sjogrens. He was right. Now he missed the clotting disorder.
Then have a clot in your lungs. Then you get taken seriously. That’s when they found factor 5 Leiden.
> disastrous consequences, especially if prescribed antidepressants
Viewed differently, this speaks to the extreme dangers of psychiatric drugs. They should be a tool (vital!) of last resort but are often used as a frontline therapy.
I agree. It should go without saying that you only get one brain.
Fundamentally, anything that modulates the brain should be used with extreme caution. Although the brain is remarkably resilient, sometimes drug-induced changes or side effects can be permanent.
For some, this may come as relief, yet for others, they may find that the solution was worse than the problem. As they say, caveat emptor.
The theory has been that if you could find a single underlying cause, you could just treat that, and then all the symptoms would disappear in one go. This would also let you treat symptoms that can't be treated directly (you can tranquilise away anxiety, you can't do much about hearing voices).
That theory has largely failed as we can't even really agree which groups of symptoms make which diseases. Hence the constant changes to systems like the DSM.
Full disclosure, I may be bias and I'm also an example: I have Major Mood Disorder. I used to have Severe Clinical Depression. Before that, I had Treatment Resistant Depression. Before that it was just Clinical Monopolar Depression (It's still called monopolar sometimes to differentiate it from Bipolar). My symptoms haven't changed. Nor has the treatments offered. But in the last 10y we've repeatedly renamed, recategorised, reshuffled etc just common depression. God knows what it's like in more complex, less common symptom sets...
The BBCs Life Scientific podcast discusses this very question in this episode if you're interested:
It amazes me how complex the brain is. We are barely equipped with the tools to understand its complexity. An article I read earlier today on HN stated that the brain contains up to 11-dimensional neural networks. [1]
I think we’ve been incredibly lucky to have the fields of psychology and psychiatry to fill the medical role, especially when the quantitative gaps in our understanding of the brain seem to be widening.
This kind of constant relabeling and recategorizing along with everyone I know who works in mental health fields constantly diagnosing everyone around them is why I am skeptical of the entire field of psychology/psychiatry.
Look at it this way. Turbulence is an observable phenomenon that you may have experienced while riding an airplane.
Modern fluid dynamics cannot adequately explain turbulence. Richard Feynman has described turbulence as the most important unsolved problem in classical physics.[1] We don’t dismiss fluid dynamics because turbulence is ill-defined, and we also don’t deny that turbulence exists just because we lack a thorough mathematical understanding of it.
This is analogous to psychology/psychiatry and mental illnesses. If we had magical brain oscilloscopes that we could hook up to visualize every mental disorder, we’d use them. Until those exist, we must rely on qualitative and statistical approaches to provide treatment.
A unipolar depression is very different from a bipolar depression in many regards. E.g. likeliness to eat less vs. likeliness to eat more.
And a unipolar depression can possibly be treated and then be gone. (If the treatment works out.) If one has bipolar disorder, it won’t go away. One has to live with it the the whole life.
