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Old 22-07-2013, 10:31 AM   #1
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Do you think mental health disorders are overdiagnosed?

Or do you think it's because we have a better understanding now in comparison to 50 years back for example.

Another example would be the increase of Bipolar disorder diagnosis in America in those under 18.

Discuss :)

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Old 22-07-2013, 10:49 AM   #2
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I think there's a bit of both, really. Things are overdiagnosed at times, but at the same time there is a greater understanding of mental illness that could also contribute to higher rates.

While I can't speak to most teens in the US that are diagnosed with bipolar, my best friend in middle school was. I don't think it was someone just over diagnosing and slapping a label on her. I also don't think her sister's diagnosis of schizophrenia was an over diagnosis. I don't think my own diagnoses are wrong (I've had the same ones since I was pre-18), although I am pretty sure a psychiatrist at one point pre-age 15 thought I was bipolar (I only say this due to the meds that particular one put me on), and I'm pretty sure that was wrong seeing as I was never diagnosed bipolar before or after that psychiatrist.

However, on the other end of things, when I was in residential treatment (in the US), there was a girl that was there that I swear did not seem to have any real mental health disorder. She seemed like any other 11 year old girl, maybe with ADHD, but nothing that I would consider out of the ordinary in terms of behaviors at all, and I lived with her 24/7 for the over 6 months she was there. She had been to a wilderness program before coming to the treatment center, so for a really young kid, she was away from home for a very long time. I honestly do not know why she was there to this day. Yes, she was rambunctious and probably hard to handle, but I really did not see anything in her behavior or from talking to her that indicated something was wrong mentally.

However my thoughts on what can get a young person sent to residential treatment in the US are probably a whole different topic, really, because they don't necessarily all require a diagnosis of a mental health disorder to send you to one.


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Old 22-07-2013, 11:05 AM   #3
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I found they they kind of over diagnosed adolescents. I was in a lot of adolescent units and my mum asked the doctor and my cpn at the time about the statistics or something.

They basically said that they err on the side of caution with under 18's because if there IS some mh issue, then it can be treated and managed more easily. Kind of nip it in the bud type attitude.



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Old 22-07-2013, 01:59 PM   #4
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I agree that they seem to diagnose under 18s too quickly.
I don't mean to invalidate adolescents experiences, I was diagnosed with psychotic depression at 15 and it was the hardest time in my life, however that was only partly due to genuine medal health problems, partly due to hormones, finding myself, being a moody teenager etc!
I personally don't think serious mental disorders should be diagnosed until the brain is fully developed, as frustrating as that can be for the patient.
In an ideal world I'd prefer they treat symptoms instead, using medication as a last resort and at a minimum dosage.



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Old 22-07-2013, 02:05 PM   #5
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I agree completely Bear.
I was diagnosed with schizophrenia at 15 and psychotic depression at 13.
They stuck me on a load of very strong medication as a first resort and I think it was more damaging than helpful.



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Old 22-07-2013, 03:39 PM   #6
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Although from other experiences I've seen many under 18's diagnosed quickly, I think a lot of it comes down to the attitude of the individual psychiatrist/doctor you are seeing.

Personally I never had a problem with being over-diagnosed. It took me hitting breaking point before they even considered an assessment, and ever since they've tried to keep my diagnoses to a minimum. They try to put all symtoms under only 1 or 2 umbrellas, and as one appeared to improve they took it off the list altogether. (Even though I still thought it was affecting daily life)

Just wanted to put my 2 cents out there.


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Old 22-07-2013, 05:16 PM   #7
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I definitely think that people are over diagnosed. I was diagnosed with five different things by the therapist I had before the one who has somewhat corrected them. I told her that I didn't feel I had borderline personality disorder because the traits that I exhibited that fit into that criteria, almost all also fit into the criteria for my post traumatic stress disorder. Whenever I started seeing the therapist who somewhat fixed them, she said that whenever she looked at the diagnoses she saw someone who didn't have much experience in treating ptsd and eating disorders and she decided that two diagnoses didn't fit. Unfortunately, I am now still stuck with them in their system because they can't figure out how to change it in their system

In addition to that over diagnosis, I was also misdiagnosed in my adolescent years, yet they missed what was actually going on. I think one problem is that they look at every behaviors as a potential symptom instead of ever looking at what could be causing the behaviors other than mental health or ever that maybe the behaviors are just temporary behaviors that will go away with age



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Old 23-07-2013, 06:47 PM   #8
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Completely mixed bag of experiences there. Thank you for sharing them. It's one of those sticky areas. We still don't know alot about the brain, yet we have moved further forward in areas of mental health but not as far as physical.
I have never been in an adolescent unit but I see so many articles or documentaries on children diagnosed with Bipolar for example in the US and I'm left thinking why don't they wait till the child is fully developed?. Help them with their symptoms and help them to get through a difficult stage but unless absolutely necessary don't give a label.
However I am not a US citizen, please correct me if I am wrong.
I only had one diagnosis under 18 but since that has been amended.

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Old 23-07-2013, 08:12 PM   #9
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I'm in the UK, and depression, bipolar and schizophrenia were the most prevalent diagnoses in the adolescent units.



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Old 23-07-2013, 09:52 PM   #10
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Quote:
Originally Posted by pb&banana View Post
Completely mixed bag of experiences there. Thank you for sharing them. It's one of those sticky areas. We still don't know alot about the brain, yet we have moved further forward in areas of mental health but not as far as physical.
I have never been in an adolescent unit but I see so many articles or documentaries on children diagnosed with Bipolar for example in the US and I'm left thinking why don't they wait till the child is fully developed?. Help them with their symptoms and help them to get through a difficult stage but unless absolutely necessary don't give a label.
However I am not a US citizen, please correct me if I am wrong.
I only had one diagnosis under 18 but since that has been amended.
In the US, to get treatment covered by insurance, you pretty much have to have a diagnosis, so that is probably a large part of it. They have to give them a diagnosis, so they choose what best fits their symptoms, even if it may change when the child reaches adulthood. For example, every therapy appointment or psychiatrist appointment I have, they have to fill out a sheet stating a brief summary of what was done and my diagnoses for it to be covered under my insurance.

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Old 23-07-2013, 11:39 PM   #11
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I too have noticed a lot of adolescents diagnosed with bipolar. One of my friends was apparently diagnosed with it but as far as I could see she was just a regular mood-swingy teenager... I never noticed her going through a depressive episode, but then again I might just not be very observant.

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Old 24-07-2013, 02:04 AM   #12
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I was under CAMHS for quite a while and was (as far as I'm aware) never diagnosed with anything. I had a hard time with CAMHS though and really struggled to engage with them, so perhaps that's why.

Adult services diagnosed me with schizoaffective disorder (depressive type) during my first hospital admission and it's stuck for the past few years. I haven't ever been diagnosed with anything else.

I'm not sure whether things are over diagnosed or not, really. I think sometimes MH professionals will see a lot of things as symptoms, when really they're just a natural reaction to things that happen in life.



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Old 24-07-2013, 02:32 AM   #13
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I think there's a lot of both. Over diagnosis is especially problematic here in the US where they need a diagnosis within their 15-30 minute assessment to get insurances to pay. I myself was horribly over and misdiagnosed, and it resulted in over three years of being heavily medicated with drugs that literally changed my personality (for the worse) and made me mentally ill and unable to function. I was diagnosed with something different every time, which was due to the lack of having a consistent psychiatrist and them trying to figure out what was wrong in a half hour and then not knowing what was me and what was cause of the meds. And I trusted them too much and took everything as prescribed, never questioning whether the meds could be causing the worsening/new symptoms.

Turns out I have ADHD, PMDD and some anxiety issues. Very treatable with fairly minimal meds. All I take now is Ritalin, although I'm considering going back on anti anxiety meds. Anyway, I was immediately diagnosed bipolar when an antidepressant made me suicidal (even though I was 17 so right in the expected group for the black box warning), and it just spiraled downhill from there. Meds upon meds upon meds. I've heard almost every diagnosis before the right one was finally stumbled upon, from bipolar, to PDs, to schizoaffective. All because of hasty diagnosis and over/mis-medication. All the while I'm being made sicker by meds my body doesn't need and can't handle, and other people who truly need them are not getting them.

At least in the US, our system is terrible at pinpointing who needs treatment vs those who don't, and then even worse at figuring out what type of treatment. It's really unfortunate because you have people who are very ill and could greatly benefit from the medication but don't get it, and then people like me who need some help but not that kind and are either not helped or sometimes even made much worse, as in my case. It's really due to the way insurances try to not pay for anything, how underfunded our state mental health systems are, and the resulting lack of continuity of care since they can't create half way decent working conditions for psychs to want to be in state care vs expensive private care. So if you're like me and in the state care for people without tons of money, it's Russian roulette whether you'll actually get something that helps you or just be made even worse.



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Old 24-07-2013, 10:45 AM   #14
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I don't know...

I was diagnosed with paranoid schizophrenia at 16 and put on clozaril. Still on clozaril but now have a diagnosis of schizoaffective disorder.

Wrong? Right? Not sure... But my doctor who diagnosed me first was the best doctor in the world and knew me very well from looking after me as IP for 16 months.



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Old 25-07-2013, 08:15 AM   #15
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I did not realise it was that bad over there in the US with insurance systems needing a diagnosis to get insurance covered. I knew that companies may not cover enough treatment but to gain access to treat you need a diagnosis almost there and then, my god. I'm sorry for the nasty experiences those of you have been through.

Neko it may not mean your not observant enough. Mental health is complex enough and sometimes people are really good at hiding they have problems. It's that "smile and no one will know something is wrong" Then again, it's difficult to be sure.

justapuppet 16 months is a long time to get to know a patient. I hope your treatment is continuing down the right path.

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Old 25-07-2013, 10:20 AM   #16
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pb&banana - yeah I seen him more than once a week, I trusted him so much. I'll never have a better doctor.



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Old 28-07-2013, 04:57 AM   #17
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Im in the US . Yes mental disorders are over diagnosed. I have been through so many bad experiences with mental health things. It is totally over diagnosed which just discuss me. People are being labeled and put on meds they don't need. Therapist are just looking for something to diagnose you with which is crazy and from what I have experienced sometimes they diagnose you with stuff over one symptom which is not right because you have to have more than just one symptom to be diagnosed with a disorder.
I have been diagnosed with so much **** its not even funny but most of it was dropped. True story on what happened to me was I had a psych that strongly thought I was bipolar she had me on Seroquel for about a year she would always call me unstable with every little thing I did. If I yelled at someone she would see it as a symptom of bipolar and call me unstable. She even wanted me on a powerful drug Haldol at one time which is scary. She had really no evidence at all that I was bipolar. She barley talked to me to figure out what I had she didn't really ask about my personal life except the normal like hows school hows work that's it. She had really no evidence at all that I was bipolar. She always said I was unstable and thought I was out of control when I really was not. I'm not bipolar at all but she still believed I was. I don't see her any more.

I'm off meds and I go to school and work and I function just fine. So yeah that's got to tell you something that Im defiantly not bipolar. Some days I just want to go back to my psych and show her that she was totally wrong about me being bipolar and tell her look at me Im off meds I hold a job and go to college still think im unstable and bipolar. She would probably be mad that I proved her wrong.

And also I have been to inpatient and been diagnosed with paranoid just because I kept looking out my bedroom door and running back in because I was playing with the staff. Mind you I was laughing and smiling while doing that. Paranoid really people? I don't think so more like wanting attention. And also I have been diagnosed with something else just because I was rolling my eyes one time. Im like are you serious I was rolling my eyes because I was annoyed about what your saying. That's what Im talking about they diagnosed me with **** over one symptom that's it which is totally not right and the fact that I was not showing symptoms of a disorder I was doing normal human emotions like rolling my eyes because I was annoyed and getting attention. Those disorders were dropped they don't think I have them now. And then when I was in in patient one of the patient told me she was put on lithium just because she was acting manic when put on a antidepressant so she was instantly labeled bipolar. I felt so sad for her that she just went along with what they said instead of realizing that they could be very wrong and there needs to be more evidence then just that.

The mental health system is messed up it defiantly needs to be fixed. Mental disorders are being over diagnosed and sometimes people are being labeled just from having one symptom when you have to have more than just one to be diagnosed with something. Some mental health processionals need to go back to school.

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Old 28-07-2013, 09:35 AM   #18
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I have to agree that I think they are quick to label sometimes. I was informed after my first assessment with the CMHT that I might have Borderline Personality Disorder. Then after my second appointment the psych narrowed it down to two possible diagnoseses Borderline Personality Disorder complicated by moderate depression, Generalised Anxiety disorder and chronic ambivalence or Major depressive disorder with Generalised Anxiety Disorder, Borderline personality traits and chronic ambivalence. Saying that it did take them nearly 5 months to decide on the correct diagnosis for me (they chose the first one).



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Old 28-07-2013, 10:40 AM   #19
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My experience has been that it's incredibly hard to get a diagnosis and treatment. I live in the UK and my MH problems started when I was 14. I saw my GP and he was reluctant to do anything but see me once every few weeks for a chat. My dad had to push to get me referred to CAMHS. They were an absolute joke- they insisted on the whole family going to the session and obviously I couldn't talk about my self harming in front of my family.

When I finally managed to see a psychiatrist for an assessment, after months of asking, she didn't seem to be able to understand what I was saying and frequently got things wrong. She told my mum that I had no mental illness, just had 'negative thoughts' and that I could have counselling if I wanted- in a town that I couldn't get to because my mum couldn't drive there and I was supposed to be in college full time any way.

I refused to see CAMHS when I turned 17 and so was sent over to adult services. My psychiatrist was absolutely horrible and frequently made me cry. By this point I was very unwell, frequently in A&E due to serious self harm and suicide attempts. I was admitted to psychiatric hospital and in ward round my psychiatrist kept saying that I didn't have depression and I was using hospital as a safety blanket and he wouldn't prescribe me any medication.

Eventually I was diagnosed with borderline personality disorder by a different psychiatrist in a different hopsital. Then last year it was changed to bipolar with traits of borderline personality disorder. I am on meds, I have been on them for 7 years now. I just wish I could have been diagnosed earlier and got the right help when I needed it.



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Old 30-07-2013, 05:16 AM   #20
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I live in the UK. I was with CAMHS from age 8 (maybe earlier but don't remember) to 14. Then from age 16-18. Then adult mental health 18+. I was in an inpatient unit at age 10 for 6 months and again at age 17 for 4 weeks. I have been in and out of specialised foster care since the age of 3. When I was 8, I was diagnosed with a severe attachment disorder (pass a child from home to home and it's inevitable, right?) this was later changed to a diagnosis of borderline personality disorder at age 17. I've seen tons of psychiatrists, yet only had 2 diagnoses. It's kind of incredible that I haven't been overdiagnosised.

Since becoming an adult, I have not had any treatment from adult services but I have been through 3 different antidepressants through my GP as adult mental health really don't take much interest. I did see one adult pysc a few times and he said I should be on antidepressants but left it to my GP to sort them...

I agree with Sherlock that it is very difficult to get treatment and the only reason I received so much from CAMHS was probably due to the fact that my social worker and foster carers fought for it. Had I lived permanently with my birth parents... well, I wouldn't actually be alive.. :P I think the UK's approach to MH is just to ignore it until it almost repeatedly kills the person or they hurt those around them.

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