the Challenges of Diagnosing Mental Health Issues

Q: the Challenges of Diagnosing Mental Health Issues

Hello, online user： It sounds like some of your symptoms are indeed troubling you, but it seems that the doctors have not yet been able to resolve your issues. <br>I recommend that you find a physician to regularly follow up with, so that they can truly understand your problems a

The doctor is unable to determine whether there is a genuine mental health issue?

Hello doctor, I started experiencing auditory hallucinations and delusions at the age of 23, but at that time, I didn't believe I was ill.
My family forced me to seek medical help, and the doctors repeatedly emphasized that what I was hearing was not real.
I was adamant that my roommate wanted to kill me.
Eventually, the doctors, unable to convince me otherwise, prescribed sedatives and allowed my parents to take me home.
I felt justified in my beliefs, convinced that someone was indeed trying to kill me.
After that, I stayed at home, afraid to even go online, fearing that someone would harm me.
The hallucinations claimed that money would be sent to me, and after waiting for six months without any sign, I began to realize that I might actually be experiencing "hallucinations." I started using the internet again and researched extensively, discovering that I didn't possess any superpowers; I was just mentally ill.
I was in dire financial straits, and my family did not believe in mental illness.
They thought it was just a matter of overthinking and that I could simply stop if I tried hard enough.
To avoid their harsh words, I needed to find a job.
After securing employment, I consulted a doctor and began medication for treatment.
That period was extremely painful as I endured constant verbal abuse from the hallucinations while trying to suppress my delusions and negative emotions.
I struggled to concentrate at work, made continuous mistakes, and felt as if my mind was splitting apart, refusing to obey my control.
The cold remarks from colleagues and the side effects of the medication led to nearly a year of insomnia.
Eventually, the medication proved ineffective, and hormonal imbalances caused me to gain weight and develop severe acne.
The doctor told me that he believed I was not ill because my symptoms did not align with those of typical schizophrenia patients.
I began to frequently change jobs due to mistakes and switched doctors as well.
The antipsychotic medications were ineffective, and I could articulate my condition and had a strong insight into my illness.
The doctors I consulted stated that they could not determine if I was genuinely experiencing hallucinations and delusions.
Even if there were issues, they suggested it could be due to other causes or brain damage, and that I did not need to continue medication since it was deemed untreatable.
I was utterly exhausted, desperately trying to live without falling into despair, yet I felt like I was deceiving myself.
I once asked a doctor if I could apply for a disability certificate, but I was dismissed as trying to fraudulently obtain disability benefits.
Four years ago, I stopped taking medication, and the doctor advised me to try to get used to the presence of hallucinations, which essentially meant relying on willpower.
I would like to ask if there are any methods available to correct brain thinking or psychological training for someone in my situation.
I have had severe social anxiety since my student days, and when I told my doctor that being around people made me so nervous that I would sweat and tremble, he prescribed serotonin-related medications to alleviate the anxiety, but they were not effective.
Could this psychological disorder be contributing to the ongoing production of hallucinations and delusions in my brain?

lynn, 30~39 year old female. Ask Date: 2020/07/06

Dr. Wang Zhenyang reply Psychiatry

Hello, online user: It sounds like some of your symptoms are indeed troubling you, but it seems that the doctors have not yet been able to resolve your issues.
I recommend that you find a physician to regularly follow up with, so that they can truly understand your problems and provide you with appropriate medical care.
If you would like to seek treatment at our hospital, we are more than willing to offer you comprehensive and continuous medical services to help you recover your health as soon as possible.
Wishing you peace and joy, Dr.
Wang Zhenyang.

Reply Date: 2020/07/06

More Info

It sounds like you have been through a very challenging journey with your mental health, and I commend you for seeking help and trying to understand your situation better. The experiences you describe, including auditory hallucinations, delusions, and significant anxiety, can be incredibly distressing and can impact various aspects of your life, including work and relationships.

Firstly, it is important to recognize that mental health conditions, particularly those involving psychosis such as schizophrenia or schizoaffective disorder, can be complex to diagnose and treat. The symptoms you have described—hallucinations, delusions, and social anxiety—are often interrelated and can complicate the diagnostic process. It is not uncommon for individuals experiencing these symptoms to feel misunderstood or dismissed by healthcare professionals, especially if their symptoms do not fit neatly into a specific diagnosis.

Your experience of feeling that your hallucinations were real and your subsequent realization that they were not is a significant step in gaining insight into your condition. This awareness, often referred to as "insight," is crucial in the treatment of psychotic disorders. However, it can also be a source of distress, as you may struggle with the implications of this realization on your identity and self-worth.

The fact that you have been prescribed medication and have sought therapy indicates that you are taking proactive steps towards managing your mental health. However, it is concerning that you have not found relief from your symptoms and have experienced side effects from medications. This is a common issue in mental health treatment, as finding the right medication and dosage can be a trial-and-error process. It is essential to communicate openly with your healthcare provider about your experiences with medication, including any side effects or lack of effectiveness, so they can adjust your treatment plan accordingly.

In addition to medication, psychotherapy can be a valuable component of treatment for individuals with psychosis and anxiety. Cognitive Behavioral Therapy (CBT) is particularly effective for addressing distorted thinking patterns and can help you develop coping strategies for managing anxiety and hallucinations. Mindfulness and grounding techniques can also be beneficial in helping you stay present and reduce anxiety when faced with distressing thoughts or sensations.

Social anxiety, as you mentioned, can exacerbate feelings of isolation and contribute to the severity of your symptoms. Engaging in social skills training or exposure therapy may help you gradually become more comfortable in social situations. These therapeutic approaches can help reduce the fear associated with social interactions and improve your overall quality of life.

It is also important to consider the role of support systems in your recovery. While it seems that your family may not fully understand your experiences, seeking support from mental health professionals, support groups, or peer networks can provide you with a sense of community and understanding. Connecting with others who have similar experiences can help reduce feelings of isolation and provide valuable insights into managing your condition.

Lastly, regarding your question about whether psychological barriers can influence the persistence of hallucinations and delusions, the answer is yes. Mental health conditions often interact in complex ways, and anxiety or stress can exacerbate psychotic symptoms. Therefore, addressing underlying anxiety and developing healthy coping mechanisms can be crucial in managing your overall mental health.

In conclusion, your journey is undoubtedly challenging, but it is essential to continue seeking help and advocating for yourself. Finding the right combination of medication, therapy, and support can take time, but with persistence and the right resources, improvement is possible. Please consider reaching out to a mental health professional who can provide you with the support and guidance you need on this journey.

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