GAD diagnosis

[Lici]

Hi, first time posting, hopefully someone can help.

So I went to a new doctor the other day (apparently he's registered with beyond blue) and he diagnosed me with GAD. The thing is I'm a bit dubious about this diagnosis as I don't excessively worry about things and have a previous diagnosis of PTSD which would fit most of my symptoms. His diagnosis consisted of asking me a few questions while I was there to see him for a shoulder issue.

I'm wondering if GAD can be diagnosed without the excessive worry and anxiety? The information that I can find on the DSM V diagnostic criteria states that the patient must have the excessive worry. The doctor has given me medication for treatment and I'm a bit nervous about starting a drug that's going to make me gain weight and be tied all the time while I'm at university (studying psychology funnily enough) and have spent a few years learning how to finally deal with things without medication. Should I ask to see a psychiatrist to get a definitive diagnosis before starting treatment? I'm really unsure what to do at the moment as I feel like the clinical psychologists and psychiatrists would have diagnosed me in the past if I had GAD.

Thanks for reading

[PamelaR]

Hello Lici

So glad you've found Beyond Blue (BB) forums - welcome. I can imagine how upsetting it would when your new doctor diagnosed that you had GAD. Though you certainly sound like you've been managing your life extremely well. If you're confident with your new doctors diagnosis, then I'd suggest going to see someone else. Additionally, it would be good to get a referral to psych or counsellor.

It's interesting how labels are used, how they stick and what they mean to people. You've indicated you were previously diagnosed with PTSD. I too have PTSD, along with anxiety and depression. But these don't define me, I just have episodes, like when I'm triggered (because of PTSD) my body then goes into anxiety and from that I become depressed. It's like a dam bursting it's wall. I rebuild the wall, then along comes another 'catastrophe' that knocks down the wall and it's time to rebuild again.

For me it's cyclic. I'm not a counsellor, doctor or therapist so I can't really say what you should do. However, it is interesting your doctor gave you medication for the GAD without referring you to a psychologist, psychiatrist or therapist. I know what you mean about not wanting to take medication. I lived 46 years without being diagnosed PTSD, anxiety and depression. I only found out 8 years ago and did not go onto medication until about 3 years later when I was in a very bad way. In hindsight I may never have got that bad if I had gone onto medication. But I'll never know.

You're doing really well Lici. Why not think about getting another opinion?

Please let us know how you get on.

Kind regards

PamelaR

[blondguy]

Hi Lici

PamelaR has provided sound support above and good on you for posting too!

I have had anxiety for many years which did heal through my GP's. A good GP is more than capable of prescribing medication for low to medium level anxiety/depression (or GAD)

This is what I have learned with my 34 years of anxiety/depression re my GP and medication

*They always had an interest in depression and anxiety and prescribes AD's where the symptoms fit the criteria

*They will refer a patient to a psychiatrist if a patient shows symptoms of a more 'complex' mental illness and not prescribe meds themselves

*Some GP's have little interest in 'getting involved' with GAD and will refer to a psychiatrist with little if any discussion

*They arent 'pro meds' or 'anti-meds' They treat anxiety as an illness with meds to improve their patients health & well being

*My GP mentioned that a pro-active GP can know more about AD's than some psychiatrists as GP's have more frequent patient contact

Many people avoid medication for various reasons however if the anxiety is still effecting our lives on a regular basis our condition can exacerbate (depending on the severity of the anxiety involved of course)

You are amazing for being as pro-active as you are Lici. The above points I mentioned above are from two GP's..one male and one female...They both had a better understanding re my anxiety than my psychologist and psychiatrist. I did have an excellent therapist that helped me out with CBT that was invaluable

I wrote a thread on the forums a while ago about GP's and Medication that many people posted on...The link below is a copy & paste and may answer some of your questions

www.beyondblue.org.au/get-support/online-forums/treatments-health-professionals-and-therapies/gp's-and-anti-depressants-important-info-

Its great that your GP is a supporter of Beyond Blue too 🙂

The forums are a safe and judgement free place for you to post Lici

I really hope you can stick around and be a part of the Beyond Blue family too!

My kind thoughts

Paul

[Lici]

Hi Pamela,

Thanks for your reply! I try not to think about the labels etc these days, my PTSD is from a single event added to a traumatic childhood. The trauma from childhood apparently made me detached so most of the time I've got a baseline of numbness but also good self awareness. Then I was diagnosed with depression in my teens and as a result went through from 18 to around 35 or 36 on different medications. I struggled and worked hard to get to a point where I thought I had a handle on things so the GAD diagnosis has thrown me a little. Medication has been somewhat helpful in the past but I'm a poor responder to ssri's so I'm dubious when it comes to trying anything new even though the doctor has given me something different this time (not an ssri). I have another appointment on Friday with him so hopefully a referral will come up then.

I found it interesting because he said that I display the anxiety physically rather than emotionally and it's why I have chronic pain, but the DSM says that there has to be excessive worry... maybe the detachment issue suppresses the worry? Most of my anxiety is usually around assignments and exams but I thought that was a normal part of uni. I think I'll definitely ask to be referred to a clinical psychologist or psychiatrist just to make sure.

I'm glad you ended up getting the help you needed, it's a huge step to take, especially when you've grown up in a time where mental illness wasn't spoken about!

Again thanks for your reply, it's nice talking to someone who understands it all, it can be quite isolating sometimes.

Kind regards,

Lici

[Lici]

Hi Paul,

Thanks for your reply, it's given me a lot to think about in terms of GPs. I have to admit that most of my experiences with GPs haven't been the best so my biases are probably getting in the way. I find that because I'm not an overly emotional person that I usually have difficulty getting a GP to help (I can't have depression because I'm not 'sad and blue' all the time etc). I guess the GAD has really gotten me confused but that could also be because of personal experiences with PTSD and panic attacks/ agoraphobia as a result so when I think of anxiety I think of being too afraid to leave my house or having panic attacks in public places etc. I don't really know what GAD entails or anxiety in general that doesn't involve PTSD (triggers etc) so have put my trouble with memory and concentration etc down to that because it's what I've known for the past 18 years to be the cause.

With medication I just never responded to them past being numb and not caring about anything and it's only since getting off of medication that I've been able to go to uni and start to live life again. So being told to take something new makes me anxious in itself as I don't want to go back to that period of my life.

I'll definitely check out the forum post you've put up. Thanks for that.

Kind regards,

Lici

[blondguy]

Hey Lici

No worries at all and thankyou for posting back too!

You will be an excellent psychologist Lici...that much I do know

I was a dill and refused meds from when I was 23 till I was 36. The first few days on my SSRI's were a little numb like yourself. They just provided me with a solid foundation on which I could heal properly using a counselor and all the coping mechanisms available

Just for me the meds gave me my life back....the agoraphobia vaporised...the bulk of the anxiety went away and my career picked up too

When I was in my 20's the 'tag' GAD didnt exist....It was only anxiety....which was scary and awful.

I understand your pain Lici

You are not alone...ever

My kind thoughts for you and a quality recovery

Paul

[Lici]

Hi Paul,

Thanks, I'm hoping that I'll be a good psychologist and that my life experience with mental illness can help others going through the same. I'm in 3rd year at the moment so still got a ways to go, but the thought of putting everything I've been through to good use is what keeps me going even when I'd rather just sleep. My grades keep surprising me enough to keep going and see if I can do better too lol

Exposure therapy with my psychiatrist at the time is what helped me get past the agoraphobia, I still display avoidance symptoms etc though. I don't think that part will ever go away really.

The meds saved my life when I was a teenager even with some of the really scary side effects I had but none of them ever got me past the numbness even after upping doses and taking whichever one I was on at the time for years before changing. After 10 different types I just decided to try living without them and it's been pretty much the same without them.

I've never been put on atypical antipsychotics though until now and reading about the side effects such as rapid weight gain and tiredness is what has me worried to even try them as this year at uni is what will determine if I get into honours and therefore continue on the path to becoming a psychologist or having to come up with a plan b.

Thanks for your kind words. I'm glad I decided to post, it seems like a very supportive community!

Kind regards

Lici

[geoff]

Hello Lici, the doctor can usually tell by your face and especially your eyes whether there is any type of mental illness, they've been doing it for a long time.

PTSD does have anxiety and your GP can and will prescribe medication for you, the trouble is that the patient will google all the side-effects and then assume that this is what they will also get.

This is a conclusion that is wrong, the medical company has to provide all the side-effects that may happen, they have to do this for legal reasons, in other words, they have to cover every angle if you take this particular drug, because if you do happen to get something that is not mentioned then the court case would be massive, if it can't be proved from something else.

Everybody is different and you can't assume that just because your friend gets a side-effect or even if it has been a great help to them, that the same will happen to you.

My GP gave me my antidepressant and yes I had to try a handful before the right one was found, whereas some are prescribed the one that suits them straight away, but I wouldn't be here if I wasn't taking my AD.

Geoff.

[Lici]

Hi Geoff,

Thanks for your reply. I realise that not all side effects happen to everyone the same way but the side effects for this one are common enough that there's peer reviewed articles discussing the weight gain side effect and the fact that the drug is also prescribed for insomnia means that the daytime sleepiness is also very common (the doctor even mentioned it). I'm not really willing to risk them straight away after a single GP visit. I realise that GPs have experience, but this is the first time I've seen this doctor and we didn't even have time to go over my mental health history. I went there because my physio told me to see a new doctor because the old one wasn't listening to me and within 10 minutes had a GAD diagnosis. It seemed very quick for a mental health diagnosis, he didn't even get me to do a DASS. It just seemed very rushed to me.

I think I'll hold off starting them until I see the doctor again on Friday where I can tell him my concerns and go over my history. He may have a different diagnosis once he knows my history properly.

With ADs, I've had a psychiatrist even tell me that I'm a poor responder and my last clinical psych agreed that sometimes they don't work for everyone, after 10 or so over 18 odd years with them all not working and a lot of therapy I weaned off of them and it was only then that I had the motivation to start uni etc. So while I'll be the first advocate to tell someone to try medication if they come to me for help, for myself I'm aware and experienced enough to know that ssri's are especially not helpful for me. Atypical antipsychotics I'm unsure of as I've never been prescribed them until now, but I've got a whole career riding on this year so the risk that it will affect my studies is something that is a genuine concern. If I was at home with not much going on I would start them, but having compulsory classes means that I just can't afford to be tired during the day.

Anyway I must get ready for uni. I hope you have a good day!

Kind regards,

Lici

[geoff]

Hi Lici, thank you so much for your reply.

I understand what you have told me and accept what you have said, so usually a double appointment with your doctor may give them the chance to diagnose you.

Atypical antipsychotics are way out of my depth and I hope that I haven't confused and/or upset you if I have my deepest apologies.

Please, can you let us know what happens, and I say this because your post will be of much interest to so many other people.

Very concerned.

Geoff.