The Importance of Following-up After a Diagnosis

A natural-looking woman rests her face in her hands while smiling.

I had hoped for clarity when I requested my paperwork from the psychiatrist’s office. Instead, I am more confused. All day today I have experienced “mixed episodes” with my moods. Mixed moods, ranging from happiness and mischievous to sadness and despair, to obsessional thoughts of the darkness in the world. Now I am obsessed with records and details again. It has only been a week or so since the clinic mailed me my paperwork- I haven’t had time to ruminate until now.

When I was a kid, I recall my mom commenting on how sensitive I was, and now I read the doctor’s notes and find he made this same observation. It’s not all the time that I feel sensitive. Sometimes I can feel quite apathetic, or envious and bitter. The clinic offered me the paperwork from both doctor’s that I met to discuss my mental health issues.

The first doctor (the one that observed that I was sensitive) gave me a primary diagnosis of Anxiety Disorder, NOS (Not Otherwise Specified).

The second doctor noted on my mental status “Excessive elaboration on insignificant issues.”

She observed my speech to be “circumstantial.”

My thoughts were logical, my grooming and eye contact were average. My insight was deemed to be “fair.”

Affect (Mood): Constricted/Blunted. I believe that means a restriction in my display of emotions, but not so much that my expression of emotions would be considered “flat.”

The second doctor’s primary diagnosis: Persistent Mood (affective) Disorder, Unspecified. She had told me that I was a “little bipolar.”

I found some information on this disorder at http://www.gpnotebook.co.uk

Persistent affective disorders are a lifetime diagnosis in patients with recurrent mild symptoms. The main persistent affective disorders are:

  • cyclothymia: (resembles a mild form of the bipolar affective disorder, with cycling between hypomania and mild depression).
  • dysthymia: (chronic low-grade depression, the symptomatology does not meet the full criteria for major depression and is not the consequence of a partially resolved major depression).

There is no resolution of the information contained in this paperwork. My mood disorder does not fit neatly into any specified category. It was noted that I was a sensitive person. It was also indicated that the previous medications caused me much distress. Yet, I was prescribed Lamictal for management of my moods. Lamictal is used to treat neuro-patients. My sensitivity and a low threshold for any nuances of chemical restructuring and balancing hinder me from taking medications.

Oppression

Sorrow and pity often accompany my thoughts when I do not have the answers. It seems I lack answers and help of “natural” man and anything temporal- I have a rudimentary existence, no true social support system (i.e., family and friends) in place for myself or kids. We have, for the most part, only each other. This may be a bit suspicious or presumptuous of me to conclude, but when people are poor, they are less inclined to have very many friends. My obvious barrier to having strong relationships is my mood disorder. When you are dealing with a myriad of emotions, it makes it difficult for others to accept you. Also, it makes it hard for you to sustain the energy and desire to handle some people.

Despair and Obsessive Thoughts

Focus on others- I think my family would be fine without me. In fact, maybe they would benefit more without me, but then I realize that being a parent means you do not back out, even if your kids would be better off without you! It means that you need to quit devaluing yourself. When I am mulling over such thoughts of hopelessness, I try to pinpoint where such negative thoughts originated in my thought pattern.

Guilt

As a parent, you feel sometimes that your kids expect too much. Too much money, too much energy. When these expectations are not met, some of us less-hearty moms feel guilty. Mothers with less emotional reserves have less to give at times. I was easily manipulated by my own guilt and insecurities. More often than I’d like to admit, I purchased things on my credit card just to “feel” better. Although the amount I spent wasn’t astronomical, it most certainly wasn’t a wise choice.

Not Otherwise Specified

The doctor said my speech was circumstantial. I discovered that means that the individual elaborates on insignificant or unrelated issues, but always returns to the primary issue.

Circumstantiality (also circumstantial thinking, or circumstantial speech) – An inability to answer a question without giving excessive, unnecessary detail.[9] This differs from tangential thinking, in that the person does eventually return to the original point. Wiki

My primary issue with this subject is “Not Otherwise Specified”. Knowing whether or not I have a particular anxiety disorder or mood disorder is a SIGNIFICANT detail towards my healing. I only wish they could have elaborated on the details. In fact, the psychiatrist who authorized the record’s release advised me to talk to her about the diagnosis. I haven’t given proper attention to prioritizing follow-up visits, mostly because I don’t want to be prescribed medication again, or I will be judged- by others and even myself.