Letting someone else talk for once–is there a diagnosis for that?

21 05 2012

I don’t only make people think, laugh, cry, or angrily comment/tweet at me. Sometimes I inspire a frustrated blog post. Our friend RealityTx is back with a dose of mental health reality. Listen closely to your substitute blogger, she’ll be reporting on your behavior to me when I return. 

Stop Diagnosing Already!

Hello, this is RealityTx here with a new dose of reality about mental health and wellness. Let me preface this by saying that I am a licensed provider in NY. In other words, I’ve been trained for this. I went to grad school for three years, did a 700 hour internship in school and did 3000 hours (yes, 3K) of clinical work post-grad plus took an exam to get my license. Ok, now that’s out of the way, I can talk about what’s been bugging me lately. SocialJerk recently wrote a post about not diagnosing fictional characters and inspired me to write about something that’s been festering within.

One of the things that annoys me about technology is the rapid access to information (and misinformation). Thanks to the internet and many other forms of technology (which I do love very much) random people think they are qualified to diagnose others. Guess what, if you haven’t gone to school for it, chances are you’ve no clue of what you’re saying.

So here is a list of things that go into diagnosing a mental health disorder (and NO, reading the DSM does not qualify you to diagnose either.) And if you don’t know what the DSM is, stop diagnosing ASAP!

  1. A recent physical with all the works. Why? We in the diagnosing field of mental health (therapists, counselors, social workers, psychiatrists, psychologists, etc.) have to figure out where symptoms are coming from. Maybe someone is woozy because they drank cold medicine and later drank. Or a child who has low blood sugar ate too much candy and is now bouncing off the walls (commonly diagnosed as ADD or ADHD).
  2. Now that I’ve mentioned symptoms, here’s another tip: don’t diagnose based on one thing. Bouncing off the walls (aka a symptom) isn’t only a sign of ADHD. Being forgetful isn’t a sign of Alzheimer’s or Dementia. Several criteria are used to determine whether or not someone has a particular disorder. After a physical (see #1), practitioners look at the symptoms (ie what is happening), the time frame (how long have the symptoms been present), the lifestyle (what’s happening in the person’s life), the age (stage of development) and level of functioning (how is the person doing in all environments). See why it’s so hard?
  3. Age is important! In mental health, age isn’t just a number. There is a reason why there are several theories of development. Freud wasn’t the only one with developmental stages (Piaget and many others). Check out books on developmental theories and you’ll see what I mean. A child, teen, adult and older adult can have different reactions to the same thing. Everyone has specific body chemistry at various stages as well as different lifestyles.
  4. Emotions are not mental health disorders people. Being happy does NOT mean a person is manic. Being sad is NOT the same as being depressed. If you’ve seen commercials about depression medication on television, some of the more recognizable symptoms are mentioned – no longer doing what interests you, frequently isolating from others, etc. But, being sad because you didn’t get a job isn’t the same as being depressed. Depression (yet another disorder that regular Joe Schmoes misdiagnose) is an on-going diagnosis that isn’t treated easily. Therapy, medication and constant work all go into treating an individual with a diagnosis. Normal is relative to each individual and all people have different kinds of normal.
  5. Medication isn’t magic. A mental health disorder is a serious thing. It disrupts your life and interrupts your level of functioning. A disorder can keep you from doing well in school, at work and/or at home. In short, it can stop a person from being the best that he or she can be. Yes, medication helps with chemical imbalances in the body, but it doesn’t automatically solve other lifestyle issues that come from having a diagnosis.
  6. Diagnoses come in several flavors – mild, moderate, severe and profound. They come in degrees. How bad do the symptoms affect the person’s day-to-day life? How often do the symptoms appear? How long is a person symptomatic during an episode? A diagnosis does not allow the person to control the symptoms alone – on-going therapy and medication and lifestyle changes help an individual manage his or her symptoms.
  7. Medication isn’t the only option. I believe in medication as a last resort. If therapy and lifestyle changes aren’t enough to reduce the frequency of the symptoms then medication can be explored starting off with the lowest dosage.

Please note that even with all of this going on, there is much more to diagnosing. So please, if you’re not a professional in the field, don’t diagnose. However, if you do see something out of the ordinary in a person’s behavior, seek professional help. Go through your doctor, school social worker or guidance department or through your insurance or employee assistance program. There are many practitioners out there. Make sure to use your best judgment to ensure that you’re loved one gets the proper diagnosis. Ok spiel over. You can now return to your regularly scheduled programming.





Social Workers of Summer

1 06 2011

Summer is here! You can tell because the fire hydrants are open. Also, the social worker showing up at your door is sweaty and rambling incoherently about camp. Getting kids into camp is not easy or fun. Tracking down updated physicals is such a nightmare that I’ve been tempted to forge immunization dates. (What, it’s not like I’ve ever done it.) And then there’s the delightful experience of navigating waitlists, because apparently everyone else getting a child into camp is some kind of psychic.

Long story short, it keeps me busy. So without further ado, I present to you my first ever guest blogger. She goes by RealityTx–for a dose of reality, one post at a time. Play nice with your new baby brother, jerks.

Camp is Craptastic

Last week found me celebrating that all of my kids had applications to camp and would be able to go. I jumped, hollered, and cheered–something not necessarily welcome in an office full of cubicles. But, my compatriots shared in my joy as I said that all of my kids were in camp.

Let me go back a bit further. Summer camp is the BANE of my existence as a child welfare worker. For most of you, the spring season brings April showers and May flowers. For child welfare workers, it brings the headache of finding a camp willing to care for the kids we work with for the entire summer, ideally for free. The best case scenario is that a local, free camp can be identified, camp forms can be filled out, and recent physical forms can be obtained.

A kid is not considered “in camp” until the full application is complete including a physical form from a doctor. I found a local free camp for one child that I work with who happens to have a sibling in care plus two foster siblings who are camp age (ie. 5-13 years old.) That’s FOUR camp applications to be completed and FOUR medical forms to obtain.

Celebrating too early can put bad juju over the entire camp registration process. That’s what I did last week when I realized that I found camps for all of the kids I work with, plus two more that I dont. (Yes, we are also required to do our foster parents a favor by locating camps for their biologica children as well, since they’re well-paid nice enough to take our kids into their homes.)

Today I call to check in to see if my kids would still be attending camp. Sure enough, the bad juju came to bite me in the ass because I was informed that all 100 slots have been filled and there is a waitlist. With a stack of at least fifty sheets of papers, no less. I was kindly invited to still submit the forms because the kids can be added to the waitlist–the person couldn’t tell me how many kids were on there anyway–so here I am, less than a week later, scrambling to find a camp for these four kids.

Apparently, forty completed applications the first day that the applications were being given out (like how the hell is that even possible?) and all one hundred slots were filled as of last week. What a difference a week makes! Maybe next week I’ll have placed all of these kids in camp, and I can really let loose with my happy dance.