The Guessing Game of Mental Health

When Psychiatrists and Mechanics Misdiagnose

Seeking medical help from a Psychiatrist for Attention Deficit Disorder symptoms has not only been unhelpful, my mental health is deteriorating at a rapid rate after treatment has started.

In my initial screening, my psychiatrist took a detailed list of all my symptoms. I can’t help but notice there were no actual tests run, though. No labs, no toxicology, and no micronutrient screening.

As someone who used to diagnose complex mechanical issues for a living, I couldn’t help but notice…this psychiatrist didn’t even open the hood.

The Cost of Misdiagnosis

A customer came to my mechanic shop complaining that his vehicle would stall intermittently while driving. In layman’s terms, the damn thing would just die for no reason while on the road.

The symptom of stalling while driving has roughly ten to twenty potential causes depending on vehicle, five of which are regular pattern failures. Sensors, computers, coils, etc. have a limited lifespan and are all likely to cause the described symptom.

The customer had already replaced all those parts, to the tune of $850 and still had the same problem.

How did I fix it? Through a diagnostic process. I formed a hypothesis of what may be the cause. I then performed a series of tests to confirm or deny my hypothesis.

My tests found a corroded wire that would lose contact intermittently. I fixed his problem for $80, and the symptom never returned.

He didn’t need more parts, he needed to find the cause.

My Mental Health and the Guessing Game

I have been having issues, and my symptoms are:

• Lack of focus and motivation

• Hyperfocus on unimportant tasks while procrastinating on important tasks

• Inability to concentrate

• Poor memory

• Difficulty with recalling words and using language

• Sitting down to work and “blanking out”–a state where I can’t decide what to do

• Impulse control issues

• Poor sleep, varying from inability to fall asleep to trouble staying asleep

I sought help from a counselor, and he strongly suggested I look into A.D.D.

After studying A.D.D. and listening to other people’s stories of struggling with it, I sought out the help of a psychiatrist.

The first “treatment” was bupropion, generic for Wellbutrin, an antidepressant that works with dopamine and norepinephrine. By week two, I felt blah. Just a general lack of feeling anything. By week three I was fully depressed and had very little will to live. I love my work, and all the sudden I found myself not wanting to work, eat, or even bathe.

Guess number one was a bust.

The second “treatment” was dexmethylphenidate, generic for Focalin, a mild stimulant used in treating Attention Deficit Disorder. While I did benefit from 2-3 hours of focused and productive work, when it wears off I feel like I’ve been hit by a truck. The crash reminds me of the hours after drinking multiple energy drinks, amplified exponentially.

I experimented with a seven day trial run taking the Focalin twice daily as prescribed. Two weeks after stopping, I still don’t like who I am. The grumpy old codger that lives in my head has been in full control.

I’m highly irritable, am having significant trouble sleeping or putting thoughts together, and feel like a wrung out sponge. I’m exhausted and feel depleted. My thoughts feel like they are covered in sludge. Words lie somewhere in the back of my brain, unable to exit the labyrinth of my mind.

I am also having significant difficulties having an orgasm. Life sucks right now.

Guess number two is a bust.

The third “treatment” is long acting methylphenidate, and all the symptoms from the Focalin are present. It just takes longer for the crash to happen.

Guess number three is a bust.

That is where I currently am, hope fading and exasperation growing.

The Difference Between Symptoms and Root Cause

Just like the customer who played the guessing game changing parts to fix his vehicle, I strongly feel like the psychiatrist is doing the same to me. They are trying to manage the symptoms without finding the cause. I'm being treated based on a hypothesis.

Some potential causes of my ADD symptoms that were not tested:

• Blood sugar dysregulation

• Poor sleep, including sleep apnea

• Trauma

• Inflammation

• Vitamin/mineral deficiencies

• Toxin exposure

• Chronic stress

Psychiatry rarely investigates these. They treat patterns, not systems. I strongly believe that treating symptoms without a diagnosis, without determining the root cause, is not only irresponsible, but dangerous.

I feel like I have gone into the doctor complaining of smoke in my house, and instead of trying to put out the fire causing the smoke, they have had me install a fan in the window to blow the smoke outside. Mildly effective at getting rid of the choking effect of smoke in my house, without actually solving the real issue.

A diagnosis without a root cause is not a diagnosis. What so many try to pass as a diagnosis is only a label that describes a cluster of symptoms.

Labels Without Understanding

Labels like anxiety, depression, ADD, PTSD, and a host of other mental maladies are not actually diagnoses. They are symptom clusters. Being labeled with anxiety does not give indication of what is causing the symptoms.

Labeling a car with a no start issue gives no indication of what needs to happen to fix the starting issue. There are dozens of potential causes for a no start issue.

It would be an extreme waste of time and money to throw repairs at the vehicle hoping one would solve the issue.

Why do we allow doctors in medicine to do this?

Labels without the understanding of the cause leads to:

• Medication that doesn’t fit

• Shame about not improving

• Potential worsening of symptoms

  • In 2004, the FDA issued a black box warning after analysis revealed an ~80% increased risk of suicidal thoughts and behaviors among children and adolescents taking SSRIs, and ~130% more agitation/hostility

• Increased insurance expenditure causing those insurance rates to rise

• In my case, a feeling of hopelessness and a sense of feeling broken

Many years ago I was treated for Hypothyroidism with thyroid medication. I didn’t improve.

Further testing, paid for out of my own pocket, found an increased level of thyroid antibodies damaging my thyroid gland, caused by inflammation due to my diet.

I changed my diet, removing fried food and refined sugar. My thyroid tests all improved. The original testing did not test for those antibodies or inflammation. Diet was ignored in the screening done by my general practitioner.

Why did I have to take things into my own hands? If I hadn’t sought out help from alternative sources, and paid for it with cash money, I’d still be on thyroid medication and still suffering from hypothyroidism.

In Defense of Psychiatry

I do want to see things from the psychiatrist’s point of view. Some people have benefited from psychiatric care enough to significantly improve their lives.

We don’t truly understand the cause of many mental health issues. Science hasn’t broken those frontiers yet. I truly hope that continued human genome discoveries will help shed light on the root causes of what plagues many of us.

Cars are man-made, therefore we have a thorough understanding of how they operate. Humans are still a mystery.

The insurance companies control much of how psychiatrists, and the medical community at large, are allowed to operate. The testing involved in a thorough diagnosis costs beaucoup dollars. My experience has been that insurance companies only pay for the bare minimum, if that. Who is going to pay if the patient cannot and the insurance company refuses?

I feel quite trapped. At this moment I cannot afford alternative treatment and the testing involved. I’m reliant on the many thousands of dollars I’ve been forced to spend on my healthcare insurance to foot the bill.

The time involved to deliver the depth of care needed for many medical issues to be truly solved is not available to practitioners. Most medical practitioners are overbooked, barely meeting client demands as they already are, much less adding extra duties to their calendar.

Most people aren’t willing to make the lifestyle changes needed to resolve their symptoms, even if they knew for sure that lifestyle was the cause. Sometimes mental health issues make it extremely hard to meet the base levels of functioning. Adding the difficulties of changing habits can be overwhelming.

Not to mention many people equate giving up hamburgers, french fries, and pizza to a fate worse than death.

Closing Thoughts

Psychiatry has helped many people. My concern is that most of the time they aren’t putting out the fire, they are merely using a fan to remove the smoke.

Just like the customer who tried parts on for size, the time and money wasted playing the guessing game are staggering. That is suffering that can be prevented with a proper diagnosis.

What is needed in the healthcare industry at large:

• More thorough diagnostics

• Integrative systems care

• Shifting from labels to understanding

A few years ago I hired a functional medicine doctor to help me sort out my health. He did a wonderful job, and I felt better than I ever had in my life. It cost more than $10,000 dollars in tests, supplements, filters for water and air, and personal coaching to change my lifestyle habits. The testing included micronutrient testing, toxicology, gut health stool tests, and more.

Thanks to a hurricane wiping out my business, I don’t have that kind of income right now to pay for that kind of care. Neither does the vast majority of our population.

But if insurance would pay to find the root cause, similar to the care I received from the functional medicine doctor, the amount of chronic issues that plague the medical system would drop, lowering long term costs. It would also drop the income of our drug companies, so that begs the question, who loses the most by changing to an effective system? I'll leave that to you, it's not my realm of expertise.

What I do know for sure, people are suffering when they don’t need to. Determining the actual cause of mental health issues would help us solve many ongoing problems that plague our mental health.

The mechanic in me knows that every system can be understood, every problem has a source, and every malfunction has a fix. The same is true for you.

Your brain isn’t broken. You’re not lazy. Maybe your wiring just needs a closer look.