Second opinion psych: what to expect?

[Cacoethes]

Hey guys

I have an apointment with a private psych for a second opinion on my diagnosis/treatment on th 24th.

Has anyine had one?
What kind of things do they ask?
Do they need to know lots aboiut your history and previous diagnoses?

thanks in advance

[Epicene]

I'd imagine it's probably much like a comprehensive first assessment. If they are private and you have referred yourself, there may not be much of a focus on previous diagnoses. I'd guess they would want to go in fresh and hear how things are for you right now, rather than having the potential of bias.

Good luck!

[Cacoethes]

thanks :)

I haven't had a proper assessment of my mh for 10 years when I was first picked up by services, since then, they've just carried on from other peoples opinions. It's a bit like Chinese whispers!

So I suppose they'd ask questions about moods, 'weird' experiences and stuff?

[sherlock holmes]

I dont think I've ever had a second opinion... oh yes I did, in hospital, but the second opinion psych got a load of notes from my other psych.

I remember being asked a LOT of questions about my mood, my appetite, my sleep, if I heard voices or saw things that other people couldn't, self harm, suicidal thoughts, anxiety etc.

I hope your assessment goes well. I'd write a list of all the symptoms you experience, even if you think it's not mental health related, and bring it with you to read from. Don't leave anything out because often what we think is irrelevant is actually very important.

My only concern is that an hour (or however long it is) might not be long enough to give you a definite diagnosis, but at least it'd give you a general idea of what's going on.

[Cacoethes]

Thanks Sarah

I think I'll ask some close friends if there is anything that's important to tell her about because some people think things are mh related when I don't, so I suppose I should mention those things too.

Yeah, I wouldn't think an hour would be long enough for anything definite, but she might at least be able to see what might need looking into or whatever. And I could always try to save up for another appointment if it would be useful.

[Angelina]

When I had mine (on NHS) it was 2 appointments 1.5 hours long, one alone and one with my carer where he poked and prodded in depth into my history, behaviours, experiences, life story...just everything.

It was just like being assessed the first time, just getting another persons perspective on it.

Good luck. xx

[Unbreakable.]

Not sure I have anything productive to say, just wanted to wish you good luck with the appointment as I know it is pretty important to you. <3

[Cacoethes]

Thank you Angelina, that's helpful :) (I don't know why I didn't see your reply before this!)

Thanks Lana x

[CagedBird]

Depends what you want out of it. Why you are requesting a second opinion etc.. I'm assuming if you think your diagnosis is wrong, it may be worthwhile explaining how you understand it, why you feel other professionals may feel you have that diagnosis but why you don't believe it to be the case for you personally. Built into this it may be useful to describe some of the issues raised to you by your friends and how they perceive them to be MH related but then offer your understanding of it.

Also, in respect to treatment it may be worthwhile explaining what you've been through previously and be honest about what treatment you have been offered, been through, but didn't actually fully commit to at the time. In particular it may be useful, for you personally, to explain your epilepsy and difficulties adhering to your medication regime for this. It may be that a lot of your 'symptoms' require untangling.

I've had a private assessment completed before. He initially asked why I was there, so essentially asked what my main issue was, as I perceived it to be. For me, I didn't explain this through past diagnoses or using mental health language but what I felt my issues were preventing me from accomplishing. E.g. exhaustion meant that I couldn't socialise with friends so I'd become isolated and lonely etc. I can't imagine a consultation that doesn't ask about your history and past mental health experiences. With 8 years in-patient, or at least closely linked to mental health services, I'd assume this would be a significant aspect you'd want to discuss!....hence the 2nd opinion you're requesting (at a guess).

[tiptoes]

I think one thing that to maybe get across is how fluxional your symptoms are, at least how you present across le interweb from one week/month to another is quite varied.

Maybe make a note the symptoms that generally present together. If there are any triggers/life events etc that can prelude the symptoms.

[Cacoethes]

CagedBird- I do think my dignosis is wrong and so do plenty of other professionals, like the CATT doctor who was aware of my history and what I was presenting with, he said I didn't fit a diagnosis, but he said that I didn't fit the BPD diagnosis.
I have no doubt that I fitted the diagnosis when I was originally diagnosed at 18, but how normal is my personality going to be when I grew up in hospital anyway?! But that's a different story!

Basically, I want an unbiased opinion on my symptoms, not necessarily diagnosis. I would expect that she would ask about my history but I would be reluctant to tell her my past and current diagnoses because that's an automatic bias and my past diagnoses have been so different to my current one. It was psychotic depression, then schizophrenia and then BPD so it would just complicate things I think.

Recently, because I've become a bit of a hopeless case, the MH people have kind of given up, like they will come to see me and chat and stuff but nothing is ever suggested or really talked about, I've pretty much been written off.

Sarah, I'll make sure to make some notes, Chels is here this weekend and she knows me better than I do! So we're gonna think of some stuff to bring up.

Thanks both :)

[Wonderland.]

I'm glad Chels is going to help you with the list of symptoms. It can be helpful to find out things from another persons point of view. Sometimes it can be hard to see our symptom as they just become normality after some time.

I really do hope seeing the psychiatrist helps

[Copernicus]

It's worth making clear early on what you're asking for - it sounds you want suggestions for how to treat things, more than another look at the diagnosis?
Hope it goes well, let us know.
x

[Cacoethes]

Thanks Ames and Copernicus :) x

Yeah, I just want to know what is going on, if anything, diagnosis isn't majorly important although I would like to get rid of it completely as I and some other professionals believe it is wrong and I'd rather not have an inaccurate diagnosis, if I have to have one at all.

[Copernicus]

Yeah I can see why you'd wonder. Just going on what I read on here BPD doesn't seem to quite fit.

[Cacoethes]

Thanks :) Hopefully she will be able to suggest some helpful things, I'm going to be discharged from the CMHT soon anyway but I just want some answers for my own benefit really.

[CagedBird]

I have no doubt that I fitted the diagnosis when I was originally diagnosed at 18, but how normal is my personality going to be when I grew up in hospital anyway?! But that's a different story!

That was my point. Being institutionalised for 8 years during crucial teenage years when you develop your sense of identity and learn how to negotiate relationships and how to cope with intense 'negative' feelings, can't have been the best environment for all these. It's interesting you feel BPD, which is a collection of fundamental beliefs and ways of interacting with the world, can fit you are 18 but not at 22.

I'm not suggesting you aren't right and you don't have BPD. Nor am I suggesting there isn't more going on. Just suggesting we're saying the same thing but from different perspectives.

I've pretty much been written off.

I thought this was what you wanted. You are rather ambivalent!

I hope you find what you are searching for.

[Cacoethes]

A lot has happened since I was 18. I've been out of hospital (bar 2 days in October) for 18 months and I had to 'grow up' fast. I formed friendships for the first time and began to live independently, a lot has changed.
I can't remember the exact point that I think I changed, but at a guess, I would say a couple of years. I think when I came out of my 2 year section.

One of the reasons I want discharge is because I've been written off. If the CMHT were able to suggest something, or if I thought they could offer something, I wouldn't be so desperate to be discharged.
I don't resent it, I've got to a point where I think I'm the best I can be and there is nothing that MH teams can help with anymore.
Even my CPN said last year that if I was convinced nothing would help, then I'd be written off as untreatable. Which I suppose I am!
But I'm ok with how things are.

[sherlock holmes]

If your second opinion assessment gives you a new diagnosis, would you take it back to your CMHT and ask them to treat you for it?

[tiptoes]

Hope your appointment has gone ok today x