fidelis
01-30-2006, 10:21 PM
I have severe PTSD and Major Depression. Because my doctor also diagnosed me with severe BPD--which is her treatment interest, she is so hung up on this diagnois she fails to properly treat and address the two AXIS I disorders I really need control of. I don't believe I have BPD--as further supported by a psychologist's assessment of me and friends who know me. I've been resigned to endure my doctor's ill management of my case up until now and have considered to seek a second opinion re: the BPD diagosis. I have consulted a major medical university and arranged for a full scale assessment of my PTSD (for purposes of assessing true severity) and to r/o BPD. My doctor has control issues and often gets defensive when I question her judgment. She is in a position to write unchallenged subjective information in my record that could potentially jeopardize my VA disability rating. Though it is my hopes that I present her with the assessment from a reputable institution--that I can't believe she could possibly ignore as so easily done with her colleague's (the psychologist) assessment--for her to review and hopefully rethink her diagnoses of me and refocus treatment attention to my untreated PTSD and under-treatment of my depression. Do you think I am doing the right thing or fating myself for case collapse? What am I not considering in this situation?
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MafiaKiddo
01-31-2006, 07:33 AM
I think getting a second opinion and a full scale assessment is a good idea but why would you still want to go to a doctor that doesn't listen to you or help. Showing her another doctors assessment isn't going to change anything.
If she doesn't want to treat or believe you have PSTD stop wasting your time and money on this doctor and find one that will help you.
Ultimately it really doesn't matter what they want to label you with as long as their main focus is helping you control or eliminate your symptoms.
To me there was a "Big Red Flag" statement in your post that if I was in this situation would find a new doctor ASAP. It's wasn't because you disagree with her diagnosis or the fact that she is not treating your other disorders although those are reason enough to leave. "Big Red Flag" is the fact that she gets defensive when you question her judgement. That is not normal or acceptable behavoir
If she doesn't want to treat or believe you have PSTD stop wasting your time and money on this doctor and find one that will help you.
Ultimately it really doesn't matter what they want to label you with as long as their main focus is helping you control or eliminate your symptoms.
To me there was a "Big Red Flag" statement in your post that if I was in this situation would find a new doctor ASAP. It's wasn't because you disagree with her diagnosis or the fact that she is not treating your other disorders although those are reason enough to leave. "Big Red Flag" is the fact that she gets defensive when you question her judgement. That is not normal or acceptable behavoir
galinaqt
01-31-2006, 06:01 PM
Does doctor ok for him to change her? I went through the hell trying to dump one.
fidelis
01-31-2006, 09:10 PM
I spoke to my doctor today and told her how I felt and my intentions to seek a second opinion and why. She got predictably upset and angry. Yes, there are serious repercussions to firing her because of my BPD label and the tight-knit relationship with her colleagues. I must stay with the VA doctors in order to keep receiving my benefits. I've already fired one doctor and had been transferred by the hand of another--the pool is dwindling. She has established an unchallenged case portraying me invidious and difficult to treat--I know of no doctor on staff that would give me a fair shake after what she has said to her supervisor and documented in my file. Do I have anything to lose by firing her? I'm not sure. I can't help to hear a colleague's voice in my head saying, "careful what you wish for." Until I actually do fire her, I will proceed by taping our sessions from here on out in my hopes to keep her honest and in line. She can say what she wants--which are usually lies--in my record, but I'll now have incontravertible evidence to the contrary.
StephanieAnne
02-01-2006, 12:10 AM
I have/had PTSD and thru therapy I realized that I also could have BPD, once I realized that I had it, it was easy for me to correct those highs and lows, could that be what your DR is seeing in you? Maybe that is why the BPD dx is there. I have gone thru years of therapy, and it has taken me along time to realize how much PTSD ran my life, I was very depressed as a child and never knew it until I was able to see clearly thru all the emotions that were running around in me.
You have a double challenge because of your disability, I say go for the outside assessment, then take that back to your DR. Because you need to stay at the VA can't you approach her knowing her control issues and explain that you feel that there are other dx's that need to be explored?
That you are trying to get control of your dx's or you want to be pro active in your care, and because she has so much insight to your case, that you feel the need to stay with her, and come to an understanding?? :rolleyes:
Butter her up!! Maybe that will change her tune. What type of dr is she?
Are you getting psychotherapy and meds? Do you have copies of your records?
You need a positive provider, one who will not make you stress because of her behavior, I am sure that having a dr who has control issues will just intimidate you and make you be the "difficult" patient that she says you are
sounds like she needs some psychotherapy :D
You have a double challenge because of your disability, I say go for the outside assessment, then take that back to your DR. Because you need to stay at the VA can't you approach her knowing her control issues and explain that you feel that there are other dx's that need to be explored?
That you are trying to get control of your dx's or you want to be pro active in your care, and because she has so much insight to your case, that you feel the need to stay with her, and come to an understanding?? :rolleyes:
Butter her up!! Maybe that will change her tune. What type of dr is she?
Are you getting psychotherapy and meds? Do you have copies of your records?
You need a positive provider, one who will not make you stress because of her behavior, I am sure that having a dr who has control issues will just intimidate you and make you be the "difficult" patient that she says you are
sounds like she needs some psychotherapy :D
ainfante
02-01-2006, 12:33 PM
Fidelis.
You are doing the right thing by wanting to find another doctor. If you read the information I wrote to Stephanie who has responded to you very postively, you probably will understand exactly what I am talking about with VA doctors.
The problem you will have is, you will not get govt. asst if you see a doctor out of the VA system. And most VA docs will side with each other. Being diagnoses with Personality Disorders won't hurt your benefits any, they might actually increase them. The only thing I want to contribute here is: when you have PTSD, one has personality changes. If it's a disorder, well doctors like to play with the word disorder since everything they diagnose they consider a disorder. PTSD people tend to have highs and lows but not like Bi-polar patients. It's mainly due to the fear, remembering and the anger we hold inside ourselves. If it is too hard for you to change doctors now, if you fight this one, she will only make it worse for you, thinking you don['t want to admit to your disorder. So this is a hard question you have to answer completely and truthfully. You are right to stand on your own and feel that you do not have this disorder, but at the same time, it takes time to change doctors and find the one who really flows with you. I know, it took my brother like 5 years wtih the VA till he found a woman doctor who was in Nam the same time he was and understood his illnesses, Diabetes from Agent Orange etc and helped diagnose him exactly on the nail. She also helped make his sugars more balanced. I hope this helps. And I really wish you the best of luck in finding a doctor who will completely understand you. It might be better to begn with someone who is more adapted to PTSD than Personality Disorders and get evaluated again.
Andrea
You are doing the right thing by wanting to find another doctor. If you read the information I wrote to Stephanie who has responded to you very postively, you probably will understand exactly what I am talking about with VA doctors.
The problem you will have is, you will not get govt. asst if you see a doctor out of the VA system. And most VA docs will side with each other. Being diagnoses with Personality Disorders won't hurt your benefits any, they might actually increase them. The only thing I want to contribute here is: when you have PTSD, one has personality changes. If it's a disorder, well doctors like to play with the word disorder since everything they diagnose they consider a disorder. PTSD people tend to have highs and lows but not like Bi-polar patients. It's mainly due to the fear, remembering and the anger we hold inside ourselves. If it is too hard for you to change doctors now, if you fight this one, she will only make it worse for you, thinking you don['t want to admit to your disorder. So this is a hard question you have to answer completely and truthfully. You are right to stand on your own and feel that you do not have this disorder, but at the same time, it takes time to change doctors and find the one who really flows with you. I know, it took my brother like 5 years wtih the VA till he found a woman doctor who was in Nam the same time he was and understood his illnesses, Diabetes from Agent Orange etc and helped diagnose him exactly on the nail. She also helped make his sugars more balanced. I hope this helps. And I really wish you the best of luck in finding a doctor who will completely understand you. It might be better to begn with someone who is more adapted to PTSD than Personality Disorders and get evaluated again.
Andrea
galinaqt
02-01-2006, 01:15 PM
What kind of help person getting if doctor who supposed to help or at least not to hurt is at war with him? How can it improve his mental health?
Too bad that you are so dependent to stay with her or her group.
Too bad that you are so dependent to stay with her or her group.
fidelis
02-02-2006, 03:48 AM
StephanieAnne,
I sure wish I would have read your reply before I saw my doctor yesterday. I was in the department on other business, so I stopped in to provide her a courtesy call that I was seeking a second opinion. She got really defensive and angry leaving me to defend my reasons for doing so: I responded by candidly telling her that I feel she gets angry and defensive whenever I express a difference of opinion or anger. I further stated that I feel I'm always walking on eggshells around her and always expending vigilance to her feelings and reactions vice focusing on my own in our sessions. I really poured salt in the wound on this comment: I said that IF it turns out Duke concurs with her finding of BPD that I would let it go and have to subject myself to her present handling of me. Ouch, I know. She did admit that the reason she won't refer or provide me access to PTSD services is because SHE doesn't get along with her colleague who performs the counseling; that her experiences with them "always becomes confrontational." I filed a complaint today through medical records assailing her with failures to treat, support and report my symtoms and problems. I don't think buttering her up at this point is going to unring the skirmish bell we've just launched. I'm going to try to get the report back later this morning in hopes that it has not been filed yet which will indeed make matters worse if it went through. I was informed by a member in her department that she has the power to destroy me in the VA and will if I fight her. She has made it so threateningly clear there at the VA that I am her patient and that nobody else is to come near me, employees (who have come to befriend me) expressed they are afraid to be seen with me or be found out that they have any associations with me! (They fear their jobs.) I also got hold of the entry she made into my record after the visit. It was filled with lies. She spent the first paragraph establishing more evidence of my having BPD (by distorting the facts and lying about what I said) and then spent the second paragraph saying I hated this VA and dotting all her proverbial "protect her ***" commentary (ie. that she advised me of x and I agreed to comply; that therapuetic services were provided to me, etc.) She told me I need seek another VA (one 3 hours away and in another state that is outside the district office that oversees and determines my disability rating) but nowhere does she confess this in her report. How convenient for her. I've decided to tape future sessions but NOT let her know I'm doing so vice letting her know. I want to build a case that establishes that she is in fact the invidious, abusive party; that will hopefully support cause for them to transfer me to another doctor, retract the progress notes she has made during my time with her, and perhaps also transfer her from the department. But then I could run up against the matter that her superiors will bury the evidence and form allegiance with her. This is an example of her abusive nature...I was in suicidal crisis looking to her for support/intervention and her nastily said response to me was "If you're thinking about suiciding, just do it. I can't stop you." I'm really scared for my mental health and treatment and retention of benefits. A former colleague of hers and a present colleague stated to me that my doctor is unstable but are afraid to come forth for fear of losing their present jobs.
I sure wish I would have read your reply before I saw my doctor yesterday. I was in the department on other business, so I stopped in to provide her a courtesy call that I was seeking a second opinion. She got really defensive and angry leaving me to defend my reasons for doing so: I responded by candidly telling her that I feel she gets angry and defensive whenever I express a difference of opinion or anger. I further stated that I feel I'm always walking on eggshells around her and always expending vigilance to her feelings and reactions vice focusing on my own in our sessions. I really poured salt in the wound on this comment: I said that IF it turns out Duke concurs with her finding of BPD that I would let it go and have to subject myself to her present handling of me. Ouch, I know. She did admit that the reason she won't refer or provide me access to PTSD services is because SHE doesn't get along with her colleague who performs the counseling; that her experiences with them "always becomes confrontational." I filed a complaint today through medical records assailing her with failures to treat, support and report my symtoms and problems. I don't think buttering her up at this point is going to unring the skirmish bell we've just launched. I'm going to try to get the report back later this morning in hopes that it has not been filed yet which will indeed make matters worse if it went through. I was informed by a member in her department that she has the power to destroy me in the VA and will if I fight her. She has made it so threateningly clear there at the VA that I am her patient and that nobody else is to come near me, employees (who have come to befriend me) expressed they are afraid to be seen with me or be found out that they have any associations with me! (They fear their jobs.) I also got hold of the entry she made into my record after the visit. It was filled with lies. She spent the first paragraph establishing more evidence of my having BPD (by distorting the facts and lying about what I said) and then spent the second paragraph saying I hated this VA and dotting all her proverbial "protect her ***" commentary (ie. that she advised me of x and I agreed to comply; that therapuetic services were provided to me, etc.) She told me I need seek another VA (one 3 hours away and in another state that is outside the district office that oversees and determines my disability rating) but nowhere does she confess this in her report. How convenient for her. I've decided to tape future sessions but NOT let her know I'm doing so vice letting her know. I want to build a case that establishes that she is in fact the invidious, abusive party; that will hopefully support cause for them to transfer me to another doctor, retract the progress notes she has made during my time with her, and perhaps also transfer her from the department. But then I could run up against the matter that her superiors will bury the evidence and form allegiance with her. This is an example of her abusive nature...I was in suicidal crisis looking to her for support/intervention and her nastily said response to me was "If you're thinking about suiciding, just do it. I can't stop you." I'm really scared for my mental health and treatment and retention of benefits. A former colleague of hers and a present colleague stated to me that my doctor is unstable but are afraid to come forth for fear of losing their present jobs.
galinaqt
02-02-2006, 10:59 AM
"If you're thinking about suiciding, just do it. I can't stop you."
Sounds like she would like you to do it, will make her life easier.
Two therapists I tried is a crime to let near people as well.
Sounds like she would like you to do it, will make her life easier.
Two therapists I tried is a crime to let near people as well.
StephanieAnne
02-02-2006, 11:49 AM
Fidelis
I think that filiing a complaint was a great idea, and don't retract it, can't you also file a complaint with your state attorney general? This provider is not doing anyone any good. You should not have to stress and worry about being treated by a professional like her, because she is not a professional. I can't believe that she has problems with collegues and does not want to refer you to them, who does she think she is? It is wrong for a provider to deny care to a patient simply because they have a conflict with another dr.
They do adhere to the Hippocratic Oath don't they?
So what about involving your some elected officials like your state senator, or assemby person? Here in NY I know when residents had problems with gov't run facilities have always contacted their elected officials for help.
The most troubling part of this for me is this, the VA is for veterans, people who have been in life changing conflicts, the VA has providers like the above one to help these people?? :confused: Something is wrong, especially with the war going on, all those people will need help in adjusting back to their normal lives and they should be getting the best care.
But, how awful for you to have to deal with a difficult provider when you are just trying to heal yourself. Keep notes on everything that you are doing, i am guessing that you live in North Carolina, and do a google search for something like nc dr complaint or something like that and maybe you can find other avenues to assist you in your fight.
Stay positive, I know it has to be difficult. I hope that the Duke assessment is soon.
I will keep you in my prayers
Steph
I think that filiing a complaint was a great idea, and don't retract it, can't you also file a complaint with your state attorney general? This provider is not doing anyone any good. You should not have to stress and worry about being treated by a professional like her, because she is not a professional. I can't believe that she has problems with collegues and does not want to refer you to them, who does she think she is? It is wrong for a provider to deny care to a patient simply because they have a conflict with another dr.
They do adhere to the Hippocratic Oath don't they?
So what about involving your some elected officials like your state senator, or assemby person? Here in NY I know when residents had problems with gov't run facilities have always contacted their elected officials for help.
The most troubling part of this for me is this, the VA is for veterans, people who have been in life changing conflicts, the VA has providers like the above one to help these people?? :confused: Something is wrong, especially with the war going on, all those people will need help in adjusting back to their normal lives and they should be getting the best care.
But, how awful for you to have to deal with a difficult provider when you are just trying to heal yourself. Keep notes on everything that you are doing, i am guessing that you live in North Carolina, and do a google search for something like nc dr complaint or something like that and maybe you can find other avenues to assist you in your fight.
Stay positive, I know it has to be difficult. I hope that the Duke assessment is soon.
I will keep you in my prayers
Steph
ainfante
02-03-2006, 09:13 PM
Good for you filing the complaint. This doctor is not for you or anyone else at that matter. How can a doctor say if you want commit suicide, do it. Jesus! Don't absorb her negativity, ok? It seems like she needs major counseling!
RWC
03-30-2006, 07:50 PM
PTSD is an insidious disorder. It can take many forms and is often misdiagnosed. I see a therapist at the Vet Center which is not related to the VA but is government funded. Since I was medically retired for PTSD, I go to the VA and the Vet Center. I only see my case worker in mental health to keep my VA disability and the psychiatrist to get meds. When I have a doctor that is a jerk (or use your own term here), I write to the regional VA office patient representative and complain. This usually gets action.
There is a patient bill of rights and your current doctor is definitely violating those rights by being such a moron. GET A DIFFERENT DOCTOR!
My symptomology presents as BPD, but the true evidence is what the causative factor is. I can go from gentle kind and caring to a raging maniac in a second. This does not mean BPD, it is typical symptomology of PTSD.
There are people out here who do care and pray for you even though we really don't know you. We too are going through our own torture but concentrating on ourselves only hurts us or at least it did me.
Peace,
rwc
There is a patient bill of rights and your current doctor is definitely violating those rights by being such a moron. GET A DIFFERENT DOCTOR!
My symptomology presents as BPD, but the true evidence is what the causative factor is. I can go from gentle kind and caring to a raging maniac in a second. This does not mean BPD, it is typical symptomology of PTSD.
There are people out here who do care and pray for you even though we really don't know you. We too are going through our own torture but concentrating on ourselves only hurts us or at least it did me.
Peace,
rwc
RWC
03-31-2006, 01:56 PM
I have never had a problem dumping a doctor except in the VA system. Since I have Medicare & Tricare For Life (retired military), I can go to any doctor I please without losing my VA benefits. Grnated, I still have to see them on a semi-annual basis, but it is better than the abuse that I could be getting. Fortunately, my primary care physician recognizes the fact that I know what I am talking about and is willing to fight for me as are the mental health personnel at the VA. The VA has me rated at 100% unemployable.
chumley1976
04-10-2006, 05:56 AM
Wow! You really know your stuff. Watch out with taking the psychological assessments. You may want to research the validity and reliability of these tests first. I think you just got a shotty therapist who is very "closed-mided". Absolutely, this is about YOU -- go for a second or even third opinion about the BPD. Trust your instincts, you know yourself the best.
Be careful--- Was this therapist referred to you by disability? You might also want to find out if "BPD" is the determining factor in your disability case. My mother was on disability for depression. In the end, disability wants you to see their doctors.
Good Luck! Great job on your research :)
Be careful--- Was this therapist referred to you by disability? You might also want to find out if "BPD" is the determining factor in your disability case. My mother was on disability for depression. In the end, disability wants you to see their doctors.
Good Luck! Great job on your research :)
Toin
04-11-2006, 08:06 PM
Ok, I'm a little confused as to whether or not you are referring to Borderline Personality Disorder or Bipolar Disorder.
I'm going to assume you mean Borderline since you refer to your other dx being on Axis I and personality d's go on II.
I am going to give you my full out and honest opinion without holding back in the least...
If your therapist/doctor is convinced you have borderline, challenging her face to face is only going to reinforce her belief that you have that disorder.
It's best, at this point, to just go through with your second opinion assessment and then bring that back to her as a medical record.
I don't think you are risking your case at all... I think you are empowering yourself by prioritizing what you need to work on.
However, at the same time, if this lady has it in her head that you suffer from a personality disorder, you have to remember that anything aside from compliant behavior is only going to reinforce her theory.
To handle her, listen to what she says, respectfully, and take great notes about your treatment and care planning. Then, carry those notes to another physician who can document the things going on within your treatment and decide whether or not you should be assigned to another physician.
Stay strong, you can do this! You just have to understand how to grease the wheels sometimes to make things run more smoothly.
I don't know a lot about VA disability but as far as SSD, I don't think PTSD is considered as strongly as bipolar, schizophrenia, or major depressive disorders. I have chronic, severe PTSD and have had it nearly destroy my life for almost 10 years and I am not eligible for anything being that it's my only psychiatric diagnosis.
As Chumley said, be careful with the testing. I work in mental health and I'm unfamiliar with assessments to gauge the severity of PTSD. When you get back, if you would share with me, that would be awesome. I'm always wanting to learn more about my illness. It seems as if the information changes so quickly...it's hard to keep up to date.
Good luck with things. Let us know how it goes!
I'm going to assume you mean Borderline since you refer to your other dx being on Axis I and personality d's go on II.
I am going to give you my full out and honest opinion without holding back in the least...
If your therapist/doctor is convinced you have borderline, challenging her face to face is only going to reinforce her belief that you have that disorder.
It's best, at this point, to just go through with your second opinion assessment and then bring that back to her as a medical record.
I don't think you are risking your case at all... I think you are empowering yourself by prioritizing what you need to work on.
However, at the same time, if this lady has it in her head that you suffer from a personality disorder, you have to remember that anything aside from compliant behavior is only going to reinforce her theory.
To handle her, listen to what she says, respectfully, and take great notes about your treatment and care planning. Then, carry those notes to another physician who can document the things going on within your treatment and decide whether or not you should be assigned to another physician.
Stay strong, you can do this! You just have to understand how to grease the wheels sometimes to make things run more smoothly.
I don't know a lot about VA disability but as far as SSD, I don't think PTSD is considered as strongly as bipolar, schizophrenia, or major depressive disorders. I have chronic, severe PTSD and have had it nearly destroy my life for almost 10 years and I am not eligible for anything being that it's my only psychiatric diagnosis.
As Chumley said, be careful with the testing. I work in mental health and I'm unfamiliar with assessments to gauge the severity of PTSD. When you get back, if you would share with me, that would be awesome. I'm always wanting to learn more about my illness. It seems as if the information changes so quickly...it's hard to keep up to date.
Good luck with things. Let us know how it goes!
3catgirl
05-21-2006, 06:23 PM
By BPD do you mean bipolar disorder or borderline personality disorder? Please clarify.
Either way, I would definitely get a second opinion. Likely your doctor will get upset and may even say some mean things to you. I would advise you to keep your cool. (Otherwise, the doctor might attribute any negative reaction you have to your "disorder".)
I had a doctor once who was convinced that I had bipolar disorder. The doctor put me on lithium, then depakote. I'm pretty sure I never qualified for bipolar disorder, but because these medications, which are prescribed for bipolar disorder, supposedly "helped" me, I was given that label. Now I'm off those medications, but still I'm listed on my chart as having a "history" of bipolar disorder. As you can imagine, this makes getting individual health insurance coverage very difficult.
Both borderline personality disorder and bipolar disorder are legitimate diagnoses -- if you indeed have these disorders. However, these disorders are overdiagnosed, especially borderline. Thus, it is likely that you may not have this disorder, even if the doctor has told you that you do. Also, once a doctor sees that you have this diagnosis, s/he will may well treat you differently than s/he would if you didn't have this label. These labels stick with you. Do whatever you can to avoid getting this diagnosis in the first place.
Either way, I would definitely get a second opinion. Likely your doctor will get upset and may even say some mean things to you. I would advise you to keep your cool. (Otherwise, the doctor might attribute any negative reaction you have to your "disorder".)
I had a doctor once who was convinced that I had bipolar disorder. The doctor put me on lithium, then depakote. I'm pretty sure I never qualified for bipolar disorder, but because these medications, which are prescribed for bipolar disorder, supposedly "helped" me, I was given that label. Now I'm off those medications, but still I'm listed on my chart as having a "history" of bipolar disorder. As you can imagine, this makes getting individual health insurance coverage very difficult.
Both borderline personality disorder and bipolar disorder are legitimate diagnoses -- if you indeed have these disorders. However, these disorders are overdiagnosed, especially borderline. Thus, it is likely that you may not have this disorder, even if the doctor has told you that you do. Also, once a doctor sees that you have this diagnosis, s/he will may well treat you differently than s/he would if you didn't have this label. These labels stick with you. Do whatever you can to avoid getting this diagnosis in the first place.