By David Joel Miller.
Have you been tested for Bipolar disorder or Schizophrenia?
More and more people come in and want to be tested or have their family member tested for a specific mental illness.
We wish there was a specific test, maybe a blood test, someone could do and then we could look at the lab report and say yes, you have Depression with a touch of ADHD. Unfortunately, it doesn’t work that way.
Mental health diagnosis or mental illness if you prefer that term. is arrived at by piling up symptoms and looking at the time you have had them to see what pattern of mental, emotional and behavioral problems the client has been experiencing.
Not everyone with the same symptoms might have exactly the same disorder. Let’s illustrate this process with a physical disorder. If you are coughing and you go to the doctor and he diagnosed you with “Major Cough Disorder.” This may have been caused by a cold, asthma or a touch of Tuberculosis. While you might take some cough drops to reduce the symptoms of the cough, regardless of the cause of the cough, you would want a different treatment for Tuberculosis or Asthma over the long run.
Treating the tuberculosis cough with a cough drop could make the problem worse by letting the bacteria get a hold and as a result shorten your life.
With a Mental illness, we go the other way. We give everyone with the symptom more or less the same diagnosis regardless of what caused the symptoms. Does it matter if you are depressed because your spouse died or because you lost your job? What if you got depressed over time because your life was just not going the way you had hoped?
For each of these causes, we would diagnose depression and prescribe eventually the same treatment regardless of the cause. So you would get an anti-depressant medication and talk therapy. If you were grieving over a loss we would let you have a period of time to grieve, say 90 days and after that, if you were still grieving we would want you to get on with life.
Parents want their kid tested for ADHD. That should be simple from one point of view. The child does not pay attention when the adult wants them to. The child does not do their work – Ipso-presto they had ADHD. Not so fast loony breath.
If we look only at the symptom then yeah, sure, all kids have ADHD some of the time when they don’t pay as much attention as the adult wants them to. But it matters a whole lot if they are not paying attention because they are being bullied on the way home or if mom and dad fought all night last night or is everything in their life fine and when they try they just can’t focus.
Bipolar Disorder is another one parents want their kids tested for. One of the symptoms of bipolar is not sleeping or getting by on almost no sleep. Kids stay up all night a lot. Watching too much internet does not make you bipolar. (On second thought can I get a grant for a million-five to study that?)
This excess energy and lack of sleep are called mania or hypomania. A manic person looks a lot like someone on Methamphetamine but they get that way without the drug.
Kids also don’t get enough sleep because pound for pound elementary school kids take in more caffeine than adults. All that caffeine comes from the sodas they drink. That much stimulant can make a five-year-old act like a drug addict on speed. Add many MG’s of an amphetamine salt to the caffeine and watch Johnny go like a cyclone. Expect that when he crashes he will get really irritable and hit someone while he is detoxing.
See why it is important to find out not just what behavioral symptom this child has but what else is going on in the family and in the kids head?
So as time passes and the facts come in the diagnosis might change, or not.
Also compounding this situation is the possibility that the client could have more than one problem. Could the Person with asthma catch a cold? Could they also catch Tuberculosis if exposed to the germ?
Someone could be depressed, have ADHD and still take in too much caffeine or do drugs. This makes unraveling the diagnosis a problem sometimes even for a professional.
So till a reliable blood test come along for Bipolar Disorder, ADHD, and the rest, we will just have to limp along counting up the symptoms and looking for other possibilities to build the correct diagnosis up over time and even then not every person responds to every treatment in the same way.
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books