This kind of 'psychiatric' problem

[spiderowl]

Have there been comprehensive medical examinations performed to rule out physical causes?

 

What diagnosis(es) have been given? Schizophrenia, Delusional Disorder, Anti-social?

 

Some examinations have taken place by pschiatrists and ordinary doctors. Also friend has had brain CT scan as I pressured doctor. The change in my friend was unusual and so bizarre and disabling I thought a scan might be needed in case of tiny stroke or something. I was pretty much told off for even thinking there could be a physical cause. But at the end of the day, what is mental illness? Why does it come out of the blue for people who have been previously OK?

 

I do not doubt that doctors have done sufficient basic blood tests and neurological tests to assure themselves that my friend's symptoms are not the result of an easily identifiable neurological disease.

 

The last diagnoses my friend was given by a doctor (what they told my friend) was that it was severe depression. In actual fact there is severe anxiety, panic, depression, eating problems, difficulty swallowing, severe and disabling muscle tension, increasing inability to get about and now leg paralysis. I realise that this may not be paralysis at all as we understand it, but severe depression seems to be minimising the situation!

Edited August 13, 2016 by spiderowl

[spiderowl]

Ok, so sorry for this. It isn't always Cinderella here either, trust me. You seem as on top of it as you could or should be.

 

I hope that your friend does receive the treatment she needs.

I hope that you are looking over your self...there is a limit to what you or any person is able to do.

If you feel she is getting the best possible and that you, as her friend, are giving what is reasonable....please do not be troubled.

 

Thank you Timshel - that's very kind of you. I am sure it is not the same everywhere in the country.

 

Obviously I am very concerned and want to help my friend but I realise there are limits to what I can do when faced with such an all-encompassing and serious problem. My friend needs to be in hospital but something more like a convalescent care home would be more appropriate (with pschological treatment and regular reviews to ensure what is being done is appropriate). I just wish things were better here. None of us would wish to be treated as an nuisance and an idiot if we were afflicted with mental health issues, nor would we want to be treated as if we were causing them ourselves.

[Redhead14]

Thank you Redhead, I can see that you understand what is involved. I know a lot about my friend because we spent a lot of time together when the illness first started and my friend stayed with me for what I thought would be a short-term patch of support while going through anxiety. It developed into more bizarre things. My friend had been trying to get help from local mental health services for months and what friend got was long waits for appointments which turned out to be triage, more long waits for groups to help with stress which turned out to be lectures on not drinking and on doing more exercise. My friend is highly intelligent and articulate (think Professor level). Eventually friend was offered CBT (months later) by which time anxiety was through the roof. Friend would not take meds, was not eating properly, avoiding various things (daren't say too much here as would identify) and became slowly incapable of doing simplest things for self.

 

Friend went to A&E on more than one occasion, visited doctors, paid for treatment with alternative therapists to help relieve symptoms (and have someone to talk to about worries no doubt) and had to do all this because there was nothing else available. I knew friend had been paying for treatments for quite a while but there was no alternative and it cost a fortune.

 

Even then, it was slow. Hospital approach was medication based and treating my friend in patronising way, telling friend they didn't have a problem and to be positive and make an effort. Therapy was based on getting friend to do things had been avoiding. Things could have been so much better but I appreciate they are dealing with some very difficult and sometimes dangerous people.

 

I completely agree that behavioural therapy was not appopriate, except to help maintain mobility and eating which is course is vital.

 

Given the physical symptoms you are reporting now, it would be imperative to have neurological testing performed.

 

Conversion Disorder could explain the paralysis and could be a response to ongoing, cumulative stress rather than the typical sudden traumatic event.

Conversion Disorder occurs sometimes with a medical illness, a dissociative disorder (which is a distinct possibility given what you said) and/or a personality disorder.

 

Eventually other friends and I ran out of mental resources to help and realised we could not (other than being supportive)

 

I know this will sound awful, but I want you to realize that the mental health system, pretty much everywhere, is limited on funds and manpower. But, the fact remains, that there are severe cases that simply cannot be unraveled even if the client receives round the clock attention and therapeutic intervention. And, mental healthcare workers can identify those cases that are on the low-end of a successful outcome or would take years and years to resolve. Your friend just may be one of those cases.

 

And, here is another reality -- your friend is highly intelligent and articulate, she can and should be held accountable for making efforts to at least manage her symptoms, take care of herself and not use the "condition" as an excuse for not doing what's necessary for herself -- i.e. taking medications, eating properly, personal hygiene, etc. If she were mentally incapacitated to the point of being catatonic, unable to speak, or unable to use logic, etc., that would be different. Her anxiety and other symptoms must be managed and managed consistently for a long period of time before other therapies can be engaged successfully, it's that simple, right now. It needs to be impressed upon her to do things for herself regularly and with dedication.

[spiderowl]

I agree with you Redhead. I hope they are doing neurological testing. They have done the reflex things, blood tests and psychology tests. I don't know what else would be appropriate. I understand there are ways to check if a patient's symptoms are caused by a known neurological illness or some kind of conversion effect.

 

I know my friend should take responsibility for not complying with possibly helpful treatments but this seems to be part of the illness - as if friend understands but at the same time can't connect the two. It is like dealing with multiple personalities - one perfectly rational and with-it, the other not connecting things up at all. It's frustrating to all concerned which is why friends have become despondent too. I do feel this could take ages and I am not convinced there is going to be a positive outcome. Friend has expressed wish to die to get out of awful situation.

 

I forgot to mention friend had jerking movements supposedly to relieve the major incapacitating tension problems suffered. They seem to have been compulsive movements and looked quite painful to be doing repetitively for days on end. These do appear to have disappeared after first round of treatment so maybe there is hope. I think sending someone home with these kinds of problems is madness itself though. But, as you say, if there is little hope of recovery in the short-term, then cost would be a factor.

 

I can only be positive with friend where possible but it sure is a strange and disturbing situation. I can see why psychiatrists have a high suicide rate. It must be very disturbing dealing with this kind of situation and not seeing it get any better. I have found it draining and depressing myself.

 

Thanks for your comments. I realise you are knowledgeable in this area.

Edited August 14, 2016 by spiderowl

[Redhead14]

I agree with you Redhead. I hope they are doing neurological testing. They have done the reflex things, blood tests and psychology tests. I don't know what else would be appropriate. I understand there are ways to check if a patient's symptoms are caused by a known neurological illness or some kind of conversion effect.

 

I know my friend should take responsibility for not complying with possibly helpful treatments but this seems to be part of the illness - as if friend understands but at the same time can't connect the two. It is like dealing with multiple personalities - one perfectly rational and with-it, the other not connecting things up at all. It's frustrating to all concerned which is why friends have become despondent too. I do feel this could take ages and I am not convinced there is going to be a positive outcome. Friend has expressed wish to die to get out of awful situation.

 

I forgot to mention friend had jerking movements supposedly to relieve the major incapacitating tension problems suffered. They seem to have been compulsive movements and looked quite painful to be doing repetitively for days on end. These do appear to have disappeared after first round of treatment so maybe there is hope. I think sending someone home with these kinds of problems is madness itself though. But, as you say, if there is little hope of recovery in the short-term, then cost would be a factor.

 

I can only be positive with friend where possible but it sure is a strange and disturbing situation. I can see why psychiatrists have a high suicide rate. It must be very disturbing dealing with this kind of situation and not seeing it get any better. I have found it draining and depressing myself.

 

Thanks for your comments. I realise you are knowledgeable in this area.

 

I strongly recommend more physical/medical testing be done. The tests you mentioned above are cursory. There are more comprehensive scans that can be done. I think that perhaps there has been too much barking up one tree or more likely the wrong tree, i.e. psychiatric. Something has been missed. If this is fairly sudden onset for most of these symptoms, there most definitely has been some physical trauma somewhere along the line like stroke or possibly poisoning of some kind? I don't know if Lyme's Disease is a problem in the UK, but here in the US Lyme's Disease is transmitted by ticks and left undiagnosed for a long time, can cause neurological and even mental health issues among other things. But, something like this maybe? Something transmitted in the water or something she eats? Just another vein of possibility to explore. Her symptoms are way outside of the diagnosis of severe depression . . . I'm thinking get out the the psychiatric box and put resources into deeper physical examinations.

 

It is very important for you to care for yourself. Give yourself some breathing space from this time to time. I realize it's difficult to give up too. Bear in mind, that you cannot be a good friend to her if you are struggling too. I use the airplane analogy -- when the cabin pressure drops, the parents are instructed to put the oxygen mask on themselves first before putting it on the children. You cannot help them if you are passed out

Edited August 14, 2016 by Redhead14

[spiderowl]

Thanks, I guess I feel they have missed something too, something that precipitated this. My friend was into herbal treatments and and was drinking some stuff she had been given for some time. I did wonder what it was. Later when friend became ill, I wondered if it had been harmful or toxic in some way, but I guess it was prescribed by a qualfied herbal practitioner. I don't know, there are so many possibilities. There were sad events in friend's life prior to this so that 'fit's the psychological theories as to symptoms.

 

Docs have decide problem is psych and there will be no more tests. Difficult to know what I can do under these circumstances as I would be fighting whole medical establishment here. I don't know what good practice would be in other countries but it seems to me if a person's life has been wrecked like this then it demands a serious look at what is happening in the brain, not just an assumption of mental illness.

Edited August 14, 2016 by spiderowl

[Redhead14]

Thanks, I guess I feel they have missed something too, something that precipitated this. My friend was into herbal treatments and and was drinking some stuff she had been given for some time. I did wonder what it was. Later when friend became ill, I wondered if it had been harmful or toxic in some way, but I guess it was prescribed by a qualfied herbal practitioner. I don't know, there are so many possibilities. There were sad events in friend's life prior to this so that 'fit's the psychological theories as to symptoms.

 

Docs have decide problem is psych and there will be no more tests. Difficult to know what I can do under these circumstances as I would be fighting whole medical establishment here. I don't know what good practice would be in other countries but it seems to me if a person's life has been wrecked like this then it demands a serious look at what is happening in the brain, not just an assumption of mental illness.

 

but I guess it was prescribed by a qualfied herbal practitioner. -- That doesn't mean that there could be some adverse affects, severe allergy perhaps, and if activated over a long period of time, it can cause damage. Even medical doctors prescribe things that patients turn out to have allergies to. They can't know who will or who will not be allergic.

 

Once a "condition" becomes multi-dimensional, multi-morbid, it's really, really hard to figure out. And, when the client isn't thinking clearly and/or cooperating, it's near impossible to get to the heart of the matter.

 

I'm sorry for your friend and you.