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- Oct 15, 2017
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Groundhog day in my consult clinic:
Pt has a history of either "depressionanxiety" or "bipolar".
I perform my evaluation.
Pt has textbook PTSD.
I discuss my findings with patient. Patient says something like "I've always suspected that but no one had ever [diagnosed me/confirmed that/talked to me about it]"
These are often satisfying visits because I can make a real difference (by getting them towards the right types of therapy and the right meds--including reducing antipsychotic use for the bipolar or psychotic disorder they do not have) but also, fill me with confusion that in the 10, 15, 20, 40 years since the index trauma(s) I'm the first person making the diagnosis. I was fortunate to receive very good trauma training including working with some excellent trauma specialist therapists. Is there a general reluctance or education gap that makes people hesitant to diagnosis PTSD? I'm genuinely baffled.
Now excuse me, I am off to perform a chart exorcism to try and banish another inaccurate bipolar diagnosis for a patient with an extensive childhood trauma history.
Pt has a history of either "depressionanxiety" or "bipolar".
I perform my evaluation.
Pt has textbook PTSD.
I discuss my findings with patient. Patient says something like "I've always suspected that but no one had ever [diagnosed me/confirmed that/talked to me about it]"
These are often satisfying visits because I can make a real difference (by getting them towards the right types of therapy and the right meds--including reducing antipsychotic use for the bipolar or psychotic disorder they do not have) but also, fill me with confusion that in the 10, 15, 20, 40 years since the index trauma(s) I'm the first person making the diagnosis. I was fortunate to receive very good trauma training including working with some excellent trauma specialist therapists. Is there a general reluctance or education gap that makes people hesitant to diagnosis PTSD? I'm genuinely baffled.
Now excuse me, I am off to perform a chart exorcism to try and banish another inaccurate bipolar diagnosis for a patient with an extensive childhood trauma history.