Somatization Disorder

[wheelchairdemon]

What do you think about the diagnosis of Somatization Disorder being given to someone who is 50 years old and has no stomach or gastrointestinal disorders?

It is possible that the doctor was thinking of the word psychosomatic - a faker - and for that reason, considered it was valid to not treat a physical ailment (a bladder infection, not a gastrointestinal disorder).

I should add, I have an indwelling catheter so infections are commonplace. I only seek treatment when the pain in my back gets really severe, I get chills, or I get too much blood in my urine.

 

[Andy]

Re: Borderline Personality Disorder frequently misdiagnosed

Are you speaking to me?

 

[wheelchairdemon]

Re: Borderline Personality Disorder frequently misdiagnosed

Not this time. I was directing the question at the administrator who, I think is a doctor or has a medical background of some kind.

I thought that, by working in the field, he might have some understanding of the proper, or improper, use of diagnostic labels.

 

[Andy]

Re: Borderline Personality Disorder frequently misdiagnosed

Oh, sorry I just wasn't sure because in the previous post I was yapping at you. lol

Well I can't speak for him obviously, but I'm sure he will be back around.

 

[wheelchairdemon]

Re: Borderline Personality Disorder frequently misdiagnosed

Yapping eh? Hey, I can tell, we're going to be two peas in a pod. Just wait till I can add pictures. I got a perfect one for yapping!! Here, I'll give you a descriptive path to the image. Go to Google, click on the word images, then in the search bar type, "yapping seagull" (keep the quotes). That image is perfectly illustrative of me!!!

I hope others love humour as much as I do... it, and the ability to find peae in nature, are my lifesavers. I'm heading out. I'll chat more later.

 

[David Baxter PhD]

What do you think about the diagnosis of Somatization Disorder being given to someone who is 50 years old and has no stomach or gastrointestinal disorders?

It is possible that the doctor was thinking of the word psychosomatic - a faker - and for that reason, considered it was valid to not treat a physical ailment (a bladder infection, not a gastrointestinal disorder).

I believe you are thinking of the term "hypochondriac", or BehaveNet? Clinical Capsule™: Hypochondriasis

A. Preoccupation with fears of having, or the idea that one has, a serious disease based on the person's misinterpretation of bodily symptoms.
B. The preoccupation persists despite appropriate medical evaluation and reassurance.

Somatization Disorder is quite different - see BehaveNet? Clinical Capsule™: Somatization Disorder

300.81 Somatization Disorder

A. A history of many physical complaints beginning before age 30 years that occur over a period of several years and result in treatment being sought or significant impairment in social, occupational, or other important areas of functioning.
B. Each of the following criteria must have been met, with individual symptoms occurring at any time during the course of the disturbance:

(1) four pain symptoms: a history of pain related to at least four different sites or functions (e.g., head, abdomen, back, joints, extremities, chest, rectum, during menstruation, during sexual intercourse, or during urination)
(2) two gastrointestinal symptoms: a history of at least two gastrointestinal symptoms other than pain (e.g., nausea, bloating, vomiting other than during pregnancy, diarrhea, or intolerance of several different foods)
(3) one sexual symptom: a history of at least one sexual or reproductive symptom other than pain (e.g., sexual indifference, erectile or ejaculatory dysfunction, irregular menses, excessive menstrual bleeding, vomiting throughout pregnancy)
(4) one pseudoneurological symptom: a history of at least one symptom or deficit suggesting a neurological condition not limited to pain (conversion symptoms such as impaired coordination or balance, paralysis or localized weakness, difficulty swallowing or lump in throat, aphonia, urinary retention, hallucinations, loss of touch or pain sensation, double vision, blindness, deafness, seizures; dissociative symptoms such as amnesia; or loss of consciousness other than fainting)
​

C. Either (1) or (2):

(1) after appropriate investigation, each of the symptoms in Criterion B cannot be fully explained by a known general medical condition or the direct effects of a substance (e.g., a drug of abuse, a medication)
(2) when there is a related general medical condition, the physical complaints or resulting social or occupational impairment are in excess of what would be expected from the history, physical examination, or laboratory findings
​

D. The symptoms are not intentionally feigned or produced (as in Factitious Disorder or Malingering).

 

[wheelchairdemon]

Thanks. Yeah, that quote 300.81 matches what I found too.

I was just asking because the label was given to me when I was in my mid-40's by a family doctor. I didn't know the diagnosis was there until I got my file in January of this year.

Here is what was written approximately 1 month after he had taken me on as a new patient. He was referring me to a specialist to do some testing because I had some numbness in my arms and hands. He accurately describes the symptoms here, but then he adds these other details. Small wonder specialists weren't to open to talking to, or carefully making an examination of, me. I was assigned this doctor in a clinic I had been in for years. The other doctor left so I just took who was assigned to me. I had no idea he was labeling me with things like Somatization disorder.

As for the word, 'hypochondriac', I was never told by a doctor that I was one. I was always accused of having psychosomatic illnesses. This was defined as, I had ailments 'that were all in my head.' The specialist tested me for carpal tunnel and the answer was negative. This made matters worse. It wasn't until I got an MRI a few years later, that I learned I had advanced degeneration of my neck and spine. My new doctor thinks the numbness comes from a pinched nerve in my neck at C7 so she is ordering more investigation. This label was given to me in 2006 so nothing was done.

Thank you kindly for seeing the above named patient regarding a buming sensation of the medial forearrn and ulnar distribution of both hands, the Rt. more symptomatic than the Left. She has had previous carpal tunnel release on both sides, the right twice, I believe. [Name removed] has a complex past history most of which fits with Somatization Disorder. In any case, she has been confined to a wheel chair for the past ten years due to dysesthesias and dyskinesias of the lower limbs. She is not presently using any analgesics or neuroleptics.​

It was reading my chart, that enlightened me. I just find the kind of reporting, copied and pasted above, as rather odd. It is very judgemental and, for the symptoms being described, the label of Somatization disorder, even if it were true, is irrelevant to the test that was being done that day.

 

[David Baxter PhD]

May I ask what point you are trying to make here?

Diagnosis is a process, where you rule out the simplest and most common causes of symptoms before going on to investigate more complex causes.

If you are trying to say that doctors are human and sometimes make mistakes, I agree with you. If you are trying to say that the state of medicine, psychiatry, psychology, and diagnosis was not as good 20 years ago as it is today, i agree with that too.

None of that means that the majority of doctors are either incompetent nor uncaring monsters, though.

 

[David Baxter PhD]

As for the word, 'hypochondriac', I was never told by a doctor that I was one. I was always accused of having psychosomatic illnesses. This was defined as, I had ailments 'that were all in my head.' The specialist tested me for carpal tunnel and the answer was negative. This made matters worse. It wasn't until I got an MRI a few years later, that I learned I had advanced degeneration of my neck and spine. My new doctor thinks the numbness comes from a pinched nerve in my neck at C7 so she is ordering more investigation. This label was given to me in 2006 so nothing was done.

Thank you kindly for seeing the above named patient regarding a buming sensation of the medial forearrn and ulnar distribution of both hands, the Rt. more symptomatic than the Left. She has had previous carpal tunnel release on both sides, the right twice, I believe. [Name removed] has a complex past history most of which fits with Somatization Disorder. In any case, she has been confined to a wheel chair for the past ten years due to dysesthesias and dyskinesias of the lower limbs. She is not presently using any analgesics or neuroleptics.​

It was reading my chart, that enlightened me. I just find the kind of reporting, copied and pasted above, as rather odd. It is very judgemental and, for the symptoms being described, the label of Somatization disorder, even if it were true, is irrelevant to the test that was being done that day.

You weren't "accused accused of having psychosomatic illnesses". You were given a diagnosis of Somatization Disorder. And to call your symptoms "psychosomatic" does not mean that you are being "acused" of faking (that would be Factitious Disorder) or hypochondriasis. The term "psychosomatic" means physical symptoms or illnesses or conditions which are either caused by or exacerbated by psychological-emotional factors.

Additionally, I don't find the quoted entry from your medicval record to be judgemental at all. I think you are reading it that way because you do not understand the meanings of the terms somatization and psychosomatic.

 

[wheelchairdemon]

Sure you can ask. My point is, labels were used and health care was refused.

To me, it seems odd that a doctor would ignore physical ailments and cite a mental health symptom instead. I guess what I really want, is to know that the experience I had is the exception rather than the rule. I know too many depressed people who have just given up, so it is starting to get to me. They used to have social networks and community supports, but those were cut down or minimized and now they are alone.

I'm next in the loneliness game. My cable had to be cut off in December and my Internet has to go at the end of this week.

Most of the people I knew have lost services too. The difference is, they have given up - they rarely go out. I will never give up and, because I am determined to go out each and every day because I know it will ward off a depression, I had to pay $194.75 for a bus last month. Those who can take conventional transit, can buy a subsidized bus pass for $44 and get unlimited rides for a month.

When I complain about the impact of loneliness I am told I have to learn to become more resilient. Resilience is a tough demand to place on someone who has a fraction of the opportunities to one who is married, has a child, an education, a job, or some other opportunity to socially network.

I'd like to challenge someone in a wheelchair to try to live alone, to not be able to reach things, to do without, and to have next to no community supports, and then see if they can keep up. Chances are, they will drop the word resilient from their vocabulary when they refer to me.

There is no one to do it for me, so I do all the things that is normally shared by couples; a parent and child, a husband and wife, a friend for a friend, etc., and I do it with no access to a car.

I point the car bit out because this community has no accessible taxi's. If I buy too much I either have to put stuff back, or take two or three trips on the bus, to carry it home. For a delivery, you have to hand it to the taxi driver, then you have to be home to take it from him. I can't be two places at once, so forget the taxi.

I am hugely resilient but social isolation is an emotional killer.

Suffice it to say I am feeling sorry for myself because the labels have led to lack of medical care from one kind of doctor, and doing super well on psychological tests has cut me off from social networks in the mental health system where I could do things with others.

I will survive. It is summer time so I spend the majority of my time at the conservation area (where I can pet everyone else's dogs and say a quick hello), go to Wolfe Island, or do as I plan to do to tomorrow - haul my butt up the stairs of a bus, go to Ottawa, and protest the Prison Farm closures. The bus is great for Community and the cause is SO worthwhile.

As for forgiveness for the doctor making a mistake - absolutely. I believe in forgiveness. There just needs to be a way to help me get over the physical barriers to work (namely lack of accessible transportation), so I can be active and more integrated in my community. Giving me labels for being frustrated by being alone and blocked from the things I used to do because of the wheelchair, is not helping me to move on in a forward fashion. When a label stigmatizes me, I am limited and isolated even more from society. Read Maslow's Hierarchy of needs and see that social contact and a sense of belonging is vital for one to maintain a sense of well-being.

I am a living, breathing human being, who loves life and will always do my best, to take part in it.

 

[David Baxter PhD]

To me, it seems odd that a doctor would ignore physical ailments and cite a mental health symptom instead.

But he didn't ignore them. That's the nature of Somatization Disorders. He gave you a diagnosis and referred you to a specialist.

 

[wheelchairdemon]

I suppose it would make sense if I KNEW I had a Somatization Disorder and was being treated for it. But I had no idea I had that disorder, or a Histronic Personality Disorder, or a Psychogenic Movement Disorder, or a Bipolar Personality Disorder, or an Adjustment disorder. At one time I was diagnosed as having a Bipolar Depressionn and BPD, but when I did the psychological testing in 2004, even these 2 labels were ruled out.

They ended up back on my chart later on, but I was not being treated for it. I was not on medicaiton and I was not seeing a psychiatrist.

That's why I found it weird to go to Emerge for something physical and, because I was sometimes upset from the amount of pain I was in, have them refer me to a psychiatrist. The pain was never treated. I had to see my Family Doctor for that.

The only reason I know I was given the other labels is I got a new family doctor and had to pick up my chart. I gave it to her but she told me to keep it. She photocopied what she needed and then handed it back. I figured, if I get to keep this, I'm going to read it. I did and that's when I found out I had 7 mental illnesses, 2 of which I knew I had prior to 2004, but were ruled out. The others were ones I never knew I had.

Oh well, it is water under the bridge now.

---------- Post added at 06:28 PM ---------- Previous post was at 06:08 PM ----------

I just realized one other missing ingredient that will explain the various diagnoses in my file. They were added by doctors of various persuasions, none of which include a psychiatrist. The label Somatization disorder came from a Family Doctor, Histronic Personality Disorder, Bipolar Personality Disorder from a Resident, Adjustment disorder from another Family doctor (they kept leaving so I took who I was assigned) and Psychogenic Movement Disorder from a neurologist.

I think it would have been better to have a professional involved to clarify whether there was a mental health issue or not. I have no idea but what I can say is I manage super well, I'm not depressed, I'm for the most part, very positive, I sleep at night, and I'm hoping to one day educate, or take part in a study, so that these issues can become a learning experience for all - the medical profession and me.