Dual MH diagnosis

[Dyess]

Is it possible to have two MH issues going on at one time? Like ADD and CPTSD? How would you know? And how would one effect the other in recovery?

[Dutch Uncle]

I think it is. I know that in the field of Personality Disorders this is called comorbidity. (In PD's there's quite often a overlap within each of the three clusters, which is why I sometimes refer to my 'cluster B'-mother (NPD, HPD, BPD, ASPD))

From Merriam-Webster dictionary:

Definition of COMORBID
:  existing simultaneously with and usually independently of another medical condition
— co·mor·bid·i·ty \-ˌmȯr-ˈbi-də-tē\ noun

Since you mention Attention Deficit Disorder:
I once saw a description of it, and it pretty much summed me up.
But I trust that the people who tried to figure out if I had an anxiety disorder, then pulled me through the SCID-II test, would have thought (when they both came out negative) about ADD if I really had it.

Perhaps if I ever go to a T (I first have to overcome my aversion to my Therapist/female parent though) I might ask for a test, or mention ADD.

[tired]

My understanding (from what I recall from a class 20 years ago on a psych rotation) is that mental health "diagnosis" isn't really a diagnosis in the sense that we are used to. It's merely a way of describing a cluster of symptoms so that when you go to a different practitioner, the first one can describe you to the next one. So if you have two clusters of different symptoms they are described separately and given separate labels.  This is different from a diagnosis of for example "brain tumor" which is clearly a fixed reality, meaning you actually have something in your head. 

Whether you should treat them separately or together may depend on what type of add, what other psychological factors are at play, etc.  Medicating two things separately is pretty risky especially if two different people treat them.  It's a good idea to think of it logically yourself and figure out what works for you right now. 

[Dyess]

Well I was wondering about the recovery process when dealing with other MH issues. Does one impair the process, and healing, of another? Many people have said I am so ADD but never been diagnosed with it, there was no need to pursue it, there was no problem as far as I could see. But if I do have it I could see where my boredom with reading lengthy information and my progress not going fast enough could be the reason I am so frustrated. That the coping skills bore me so much they cause anxiety. Kati Morton just released a video with a guy that had recently been diagnosed with ADD and he is in his 40's, a successful business man. He commented on how coffee helped stimulate the frontal cortex and helped him think clearer. I remember going to high school and if I had a test I would buy some No Doz, caffeine tablets, and would do well on the test. That was interesting to me.

[Dutch Uncle]

I'm reading through Peter Walker's Outer Critic article (http://www.pete-walker.com/pdf/ShrinkingOuterCritic.pdf) and he says there "Complex PTSD typically includes an attachment disorder, "

I just wanted to share this, perhaps it's of help.

[Dyess]

That was interesting , thanks for sharing.

[spemat]

my diagnosis of hyperactive ADHD after my first manic episode (runs in family) was the the part of my complex PTSD.

[Dyess]

Thanks for sharing  Spemat, and welcome to the forum. Was that a recent diagnosis for both?

[tired]

I want to point out something I think is important.

It makes more sense for the patient (us) to think of ourselves as unique individuals and consider each symptom and how it occured separately and in the context of our own history. A diagnosis is for the clinicians, so they can summarize, or generalize, for convenience and record keeping.  It may be that all of us with c-ptsd have very similar paths. It may be that everyone with ADD has some really striking things in common.  But I don't think that's what therapists are saying when they attach the labels. They are only identifying a certain set of things.  The reality is probably (I am guessing) that each of us has more or less different reasons for our symptoms.  For example, a lot of us have social anxiety.  What type of trauma produced this? or is it because of something else? Or a combination? 

Anyway my point is to take the labels with a grain of salt and recognize how and why they were developed.  I think of it this way; if I'm organizing my bookshelf I might organize them according to topic or maybe alphabetically.  I personally have organized them all by color and spent about 3 hours making sure they were in order of hue.   It's just a way to organize a bunch of things that can't really be divided into discreet groups.   

Sorry I'm in ocd mode right now with all things.  a lot of ritalin and redbull and trying to organize my house.

[Dutch Uncle]

Personally, I think you paint a bit too bleak picture of the "how and why [diagnosis/labels] were developed".
If somebody falls from a considerable height and then have a problem with their ankle, the diagnosis 'broken' or 'sprained' does serve a much larger purpose than just 'convenience' for the 'clinician'.
It actually is a tool in determining whether the ankle should be put in a cast, or if rest and gentle reapplying of pressure/stress is the relevant treatment. Does your GP send you on to a hospital, or does (s)he send you to a physiotherapist? His/her diagnosis will help him/her to determine what's the best course to take.

My two cents.

[tired]

I don't really know; it's what I was told in a class about how the whole dsm was started.  It's saying mental health diagnosis isn't as scientific as other medical diagnoses.

[Dutch Uncle]

In what way? Isn't it 'as scientific' because the method isn't scientific, or is it because empiric evidence is scarce/less well definite?

Probably the latter is the case, as 'mental health issues' are so dependent on the subjective reporting of the 'patient'. In this sense all science done in the 'humanities' (f.e. sociology) does struggle with obtaining valid, significant, data on which to build solid theory.
Which would mean the scientific evidence is 'soft'. But not the science behind it.
But I'm well digressing into the topic of 'Philosophy of Science' now.

I do agree though that physical health diagnosis have a much firmer 'scientific' (read: empiric) base as far as measurable, determinable cause-and-effect is concerned. But even physical medical science is 'vague' in comparison to physics, chemistry and other 'exact' sciences. It doesn't make it a 'lesser' science though. (despite the claims of physicist et al.  )

[MaryAnn]

Hi Trace,

Here is an article that may help with your question.  DU's definition is correct for comorbid. 

http://www.medscape.org/viewarticle/418740

My husband is diagnosed as ADHD and from what I can tell, it is a genetic form of ADHD.  I have not been tested for ADHD, but with the severity of my anxiety, depression, and CPTSD,  I feel like I am suffering from ADHD.  Forget things quickly, can't stay on task, stay focused, bounce from one idea or thought to another, making it difficult to get anything done.  A tough one for me, was never that way until the last 2 yrs or so.  It is making the anxiety worse to be sure.  A couple of months ago I was prescribed Wellbutrin (the generic is the bupropion talked about in the article) and it has helped me to focus and concentrate more, slow down my thoughts some.  But the anxiety is still there, just not as intense.  Indicating that what I think is ADHD is a co-occurrence with the depression and anxiety, both which were brought on by CPTSD.  Or that the ADHD was a result of the CPTSD and depression and anxiety that followed once I had enough and couldn't manage the stress or beating myself up anymore.

Comorbidity is common with ADHD and other disorders, especially PTSD or Anxiety, from what I have read.  This article indicates that both need to be treated simultaneously, not one before the other.

Thank you Trace for this post.  It was an interesting topic to research and the information that was online was definitely helpful to me, but hopefully will be to others as well.

MaryAnn 

[Dyess]

You are most welcome MaryAnn, thank you for your contribution. Sometimes it just amazes me at the thought and resourcefulness of this group. Can you imagine if we all lived close to one another the things we could accomplish ?  You can spend hours, and days researching such things but with our members we research and bring to the table what seems to be the most important, making it easier for those that will come after us and they can add their contributions. One day we will look at this say..remember when CPTSD was not in the DSM ?