I do not normally write on a personal level, but I felt I had to share this ‘Diagnosis’ I received in the post today after two sessions with a psychiatrist. I feel I must add that being outspoken or in any way knowledgable regarding your own condition, is a definate NO.
Not speaking is equally damning, as is asking questions and speaking out about any doubts you may have regarding the treatment you have received.
(I have only omitted the personal details)
Welcome to my world….
“I met with you on the 14th of February 2013 at my clinic at ………
My GP Trainee colleague, Dr …………. was also present.
The consultation lasted for approximately 90 minutes, I have summarised our discussion arising out of it and have copied your GP into the letter for information and advice.
Severe ADHD, Mixed Personality Disorder – Anankastic, Paranoid, Narcissistic and borderline type Past History of Bipolar disorder.
Not on any Psychotropic medication.
Treatment options discussed/suggested.
1. You are not taking any medication at present, you have discontinued the Quetiapine I had prescribed previously.
2. I discussed medical treatment options for the core symptoms of impulsivity and restlessness adult ADHD. You did not wish to continue medical treatment for Adult ADHD.
3. I have also discussed a referral to the local Personality Disorder Therapeutic Community (TAITH).
4. Your Appropriate Adult brought up the issue of referral for counselling for abuse she says you suffered at a children’s home over 30 years ago. The options include referral to Stepping Stones in Wrexham, RASA (in Flintshire).
5. I have previously discussed a referral to the Life Coach Service to address social activity and introducing structure to your day.
I have also confirmed that you cannot be coerced into any of the treatments.
I have not made any arrangements to follow you up in clinic. Should you wish to follow up any of the above treatment suggestions please do not hesitate to contact me.
Summary of key issues identified in the appointment:
I discussed with you and reviewed in detail your responses on the self-reported personality disorder questionnaire: my assessment indicates that you suffer from a mixed personality traits/disorder. You meet criteria for Paranoid personality disorder, Anankastic personality disorder, and exhibit Narcissistic and borderline personality disorder.
Your self-report on the Conner’s Adult ADHD Rating Scale indicate Severe ADHD with problems of inattention, hyperactivity and impulsivity. The ADHD Scale assessment indicated problems with self-concept which was collerates with symptoms of borderline personality disorder.
Your reactions to my assessment and opinions were as follows:
- You disagree with the diagnosis of ADHD and personality disorder, although you have corroborated both by self-report and during our assessment. You said that you have had several diagnoses given to you in the past and you no longer believe the opinion of the doctors. You however did agree that the psychology of the personality characteristics you display are centred on reducing risk to you and acting as a “Bullshit Detector.” Your appropriate adult corroborated your reports on your personality questionnaire and she confirmed that it has taken over six years to earn your trust which is a core symptom of paranoid personality.
- You also told me that you are not taking any medication at present.
You cited being a Rh Negative blood group as a physical characteristic which precludes a response to medication.
- You also reported receiving ECT treatment and being detained many years ago in Broadmoor, for which we are unable to obtain medical records. You feel that the ECT may also explain some of your behaviour.
- You also stated that my diagnosis of ADHD had been influenced by the big pharmaceutical companies which are trying to peddle medication for profit.
The main concerns revolve around you going into town and getting into trouble and impulsively picking up fights. There are no concerns about your ability to care for your children when you are at home. Other examples of impulsive behaviour include the police being called to a housing meeting, when you were living in Bala, as you appeared ‘intimidating.’ You were excluded from the local supermarket for the same reason. After moving to Wrexham you got into an argument with the Head Teacher at your child’s new school. You do not consider any of this being a problem as you feel you are only speaking your mind. You have a very high opinion of your intelligence and feel unable to tolerate boring people and their conversations. This leads to the impression of an arrogant attitude and speaking out what you are thinking, as taught by your father and Grandparent’s. You do not seem to care for the impact this has on the person receiving this criticism which is most times uncalled for and it puts you at a risk for retaliation. It has also been reported that you tend to exhibit other risky behaviour such as walking across the tops of high bridges which have been a cause of public concern. It has been discussed that there is an ongoing investigation into the abuse of children whilst in care in Wales in the seventies. Your appropriate adult told me that the police had informed her that they believe you might have been sexually abused also, although you have not reported any abuse during our meetings where she had been present. Even after those comments were made you did not respond to them. It has also been mentioned that Social Services had been involved and there has been a discussion of referral for counselling.
It has also been reported that you walked out of an ATOS interview as you felt that the medical person at the panel did not have the relevant skills to assess you.
On MENTAL STATE EXAMINATION I did not identify any symptoms of mental disorder. You had a sarcastic and oppositional attitude to all that I had to say during the interview: For example you said that if you knew what your problem was you would then be able to start thinking about how you would manage it – but when I offer my opinion on what your problem is you immediately rejected it. You reported being able to understand how the medical/psychiatry profession tends to have different hypotheses for psychiatric disorders – but you said that you had a low level of intelligence. You refused to consider any of the treatment options offered, e.g. When I discussed the therapeutic community for personality disorders, you felt that you would not be able to cope with meeting people with similar problems and that you might be driven to drinking or drugs.
I have identified that you have the capacity to make your own decisions around your treatment and have the capacity to refuse.
My assessment of your risk is that because of the untreated adult DHD, you remain at risk of impulsive behaviour and getting into serious trouble because of your impulsive behaviour whilst in public.”