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Something’s not right

Former-Member
Not applicable

When one serious diagnosis is not enough...

My partner has had two psychiatrists over the last six months, they both agree she has schizoaffective disorder.  One of them also believes she has borderline personality disorder while the second one is strongly opposed to that diagnosis. How am I as the carer supposed to help my partner when I do not even know what is wrong with her.  Based on my understanding of the two diseases and my own independent research I am inclined to believe she has both but I have such doubts.  How do you guys deal with doubts when the pros are being dopes.

7 REPLIES 7

Re: When one serious diagnosis is not enough...

Hi @Former-Member,

That sounds very frustrating to be supporting your partner who is receiving conflicting diagnoses from different psychiatrists. It sounds like you are really committed to providing her the best support possible and want to have all the relevant information to do that.

I'm reminded of this thread 'Getting the right diagnosis' which @Darcy, @Former-Member, and @Kristina contributed to. 

Take care Smiley Happy
Tortoiseshell

Re: When one serious diagnosis is not enough...

Thank you @Tortoiseshell

Re: When one serious diagnosis is not enough...

Hello @Former-Member

My Mr Darcy has had a number of different diagnoses tendered by different pdocs so I can understand your frustration.  In psychiatry there are  a heap of symptoms that can point to a number of diagnostic possibilities and seeing patients at different phases of conditions can lead different pdocs to different conclusions which may account for the situation you find yourself in.

A wise pdoc once told me that she operates on what she calls a "diagnosis hypothesis", that is, as she interprets the things that pdocs do and formulates diagnosis, there may be more than one possibility for what could be causing the problem. A treatment plan is made with a 'working diagnosis' - that is the disorder she feels is the most likely and on which treatment is based.  Time is often a big factor, as the pdoc gets to know the patient, makes further observations, finds out more of their history and symptoms. the diagnosis might be tweaked or changed, with some conditions being ruled out, others included.  

So ... how can this help you with coping and knowing what to do?

From what you have said, your partner appears to have a confirmed diagnosis of schizoaffective and there now appears to be a difference of opinion as to whether or not an additional diagnosis of BPD applies, perhaps this could be viewed as a 'diagnosis hypothesis' and adopting a 'wait and see' approach might be one to consider with a view to this either being confirmed or ruled out as the pdoc continues to monitor and treat.

In the mean time, with your partners consent,  the questions that I would be asking the pdoc are:  

- How would this additional diagnosis affect the treatment that my loved one is having?   Is so, what does this involve?  

- is there anything I as a carer need to do differently that will help my loved one?

 

Hope this helps

Darcy

Re: When one serious diagnosis is not enough...

@Darcy  Thank you for your thoughtful reply.  That is just thing. I do not know if there is anything I should be doing differently and not being told by the pdocs is very unhelpful. I LOVE My partner and want what is best for her. I feel like I am in a rut until some kind of solid foundation on what is the fundamental diagnosis is made. I understand the working diagnosis theory and I like it but I am still worried.  Does this make sense?

Re: When one serious diagnosis is not enough...

It does make sense @Former-Member most of us do worry if there is an unknown factor.  Being a carer we do have concern for our loved ones and want the best for them. 

If your partner is happy to, she could specifically ask the pdoc if they would be happy to explain to you the treatment plan and this might help put your mind at rest (it certainly helped with me); this could be done at the end of one of her consultations. They may give you specific instructions as to things you can do as a carer that would be helpful that would assist them.

Quite often a pdoc will refer to you a psychologist or other counsellor for dedicated psych education - these are sessions that are specifically tailored to help family (including partners) and patients sort through common issues and how best to handle them in light of various psych conditions. If your partner and therapist are comfortable with this, her therapist might be happy to give a dedicated couples sessions that will give more specific guidance as to how you can help; any such sessions would be done separate to any therapy that she is having. Some mental health support groups such as Wellways also provide psych education services that help both carers and patients. Here is a link to their website: 

https://www.wellways.org/

It is important for our own health as carers to learn how to cope when things are uncertain - do you have your own psychologist that might be able to help you with this?

Darcy

 

Re: When one serious diagnosis is not enough...

How are you going @Former-Member

Re: When one serious diagnosis is not enough...

It has been a rough couple weeks. I am back now.

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