ptsd While I Am At It...pscyh Help Please

[tec]

Tues I also have appt with a psychiatrist to evaluate me for depression/anxiety and minor PTSd...the depressions/anx. is secondary to current disabilities and from not ever "civialianizing". My current psychologist diagnosed me with depression/anxiety for the never civilianizing and secondary also because of my current ortho disabilities and outlook, passive ideologies, and some PTSD.

I have a letter with that from her. The psychiatrist i am seeing is a civilian out town subcontracted to QTC. I will show her that letter, will it help? My psychologist also said to tell her that since having to retire, my depression and mood probs have intensified as I used the work to run from the probs.

But she also a year ago did the tests of concentration, memory and such and I passed but i was on meds then and was working.

Should I use this letter? Advice? Any references to study so I can prepare as i have never dealt with the psych realm before. How hard is it to make one of theirs see that your depression is partially secondary to the service conditions? I read a lot about GAF scores and saw a chart....I see some of mine on there in different places...but don't understand. I have "passive" suicidal ideologies, but on the chart there is only one-suicidal ideologies.....so where does the passive part fall? All I know is that if given the chance to die without me doing it I would take it in a heartbeat. death has as much attraction to me as life,

But anyway, any reading I can do, or advice on how to deal with one of their psychiatrists and get the conditions across? thanks...t

[Wings]

Tues I also have appt with a psychiatrist to evaluate me for depression/anxiety and minor PTSd...the depressions/anx. is secondary to current disabilities and from not ever "civialianizing". My current psychologist diagnosed me with depression/anxiety for the never civilianizing and secondary also because of my current ortho disabilities and outlook, passive ideologies, and some PTSD.

I have a letter with that from her. The psychiatrist i am seeing is a civilian out town subcontracted to QTC. I will show her that letter, will it help? My psychologist also said to tell her that since having to retire, my depression and mood probs have intensified as I used the work to run from the probs.

But she also a year ago did the tests of concentration, memory and such and I passed but i was on meds then and was working.

Should I use this letter? Advice? Any references to study so I can prepare as i have never dealt with the psych realm before. How hard is it to make one of theirs see that your depression is partially secondary to the service conditions? I read a lot about GAF scores and saw a chart....I see some of mine on there in different places...but don't understand. I have "passive" suicidal ideologies, but on the chart there is only one-suicidal ideologies.....so where does the passive part fall? All I know is that if given the chance to die without me doing it I would take it in a heartbeat. death has as much attraction to me as life,

But anyway, any reading I can do, or advice on how to deal with one of their psychiatrists and get the conditions across? thanks...t

I think the letter your psychologist wrote would be helpful to your QTC examiner! If s/he doesn't have the time or inclination to read it prior to your exam, make sure you leave a copy with them before you leave the office! The psychiatrist will spend a good part of the exam giving you a "mental status exam". Their job is to evaluate your current level of functioning, so I would suggest trying to stay with the present time, and talk about your Service-Connected physical disability - how your mental problems are the result of being physically disabled. Really let them know how every area of your life is impacted. If they want more testing done, let them suggest it; no need to present last year's data if your condition has worsened. If the meds help, tell them that it helps to a certain degree, but you are still feeling suicidal, vulnerable, hopeless, frightened, etc. Wish you the best of luck. Keep us posted!

[Pete53]

Good Luck I agree with Wings.

[jimlane1949]

Tues I also have appt with a psychiatrist to evaluate me for depression/anxiety and minor PTSd...the depressions/anx. is secondary to current disabilities and from not ever "civialianizing". My current psychologist diagnosed me with depression/anxiety for the never civilianizing and secondary also because of my current ortho disabilities and outlook, passive ideologies, and some PTSD.

I have a letter with that from her. The psychiatrist i am seeing is a civilian out town subcontracted to QTC. I will show her that letter, will it help? My psychologist also said to tell her that since having to retire, my depression and mood probs have intensified as I used the work to run from the probs.

But she also a year ago did the tests of concentration, memory and such and I passed but i was on meds then and was working.

Should I use this letter? Advice? Any references to study so I can prepare as i have never dealt with the psych realm before. How hard is it to make one of theirs see that your depression is partially secondary to the service conditions? I read a lot about GAF scores and saw a chart....I see some of mine on there in different places...but don't understand. I have "passive" suicidal ideologies, but on the chart there is only one-suicidal ideologies.....so where does the passive part fall? All I know is that if given the chance to die without me doing it I would take it in a heartbeat. death has as much attraction to me as life,

But anyway, any reading I can do, or advice on how to deal with one of their psychiatrists and get the conditions across? thanks...t

I worked for 25 years as a clinical social worker before my medical retirement. I am not sure how to phrase this but I'll give it a go. When being seen by a mental healh professional, ie; psychiatrist, pyschologist, or social worker, you are either suicidal at that point in time or you are not. What the examiner has to do if you say I'm going to harm myself and you explain to them that you know how to do it and have the means, you have a plan, and they will have you hospitalized either voluntarily or ask for a 72 hour commitment order for observation. At the end of 72 hours if you are still feeling suicidal the Psychiatrist in charge of your care can in most states request an additional five days for continued evaluation and treatment. Since I am not a DR. I would discuss your feelings with a board certified psychiatrist. Psychologists and Social Workers can provide the Psychiatrist with a clinical impression but not a diagnosis. Wishing you the best.

Jim Lane TDIU T&P

[Wings]

I agree with Jim. "Suicidal Ideation" means having thoughts and ruminations, but lack intent. If, on the other hand, you have a definitie PLAN all worked out - - they should hospitalize you!

Edited October 31, 2005 by Wings

[carlie]

I know this is just copy & paste but I think it might be helpful reading material for your claim and maybe help some other vets too.

Good luck,

carlie

major depression

A clinical syndrome that includes a persistent sad mood or loss of interest in activities tha§ 4.125 Diagnosis of mental disorders.

(a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by the findings on the examination report, the rating agency shall return the report to the examiner to substantiate the diagnosis.

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Title 38: Pensions, Bonuses, and Veterans' Relief

PART 4—SCHEDULE FOR RATING DISABILITIES

Subpart B—Disability Ratings

Mental Disorders

( If the diagnosis of a mental disorder is changed, the rating agency shall determine whether the new diagnosis represents progression of the prior diagnosis, correction of an error in the prior diagnosis, or development of a new and separate condition. If it is not clear from the available records what the change of diagnosis represents, the rating agency shall return the report to the examiner for a determination.

t persists for at least 2 weeks in the absence of external precipitants. This should not be confused with a grief reaction (death of loved one). Features may include change in eating habits, insomnia, early morning wakening, lack of interest, depressed mood, fatigue and suicidal thoughts.

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§ 3.310 Proximate results, secondary conditions.

(a) General. Except as provided in §3.300©, disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition.

[Jay Johnson]

Suicidal ideation is not, necassarily, reflected in your GAF score. Most clinics have their own "suicide scale" to determine exactly how probable any suicide attempt may be....some facilities have very strict charts on suicide and others have no chart/scale at all (nothing universal to my knowledge).

Anywho, for your exam I would just be yourself...do NOT try to impress the doctor or go out of your way to look "normal". Make sure you emphasize your bad days and try to stay play down your good ones...the way the regs read (and the way the docs are supposed to evaluate) is that they should take consider how bad you get and how often you get that way. Your good days should not factor into the evaluation, but the C&Ps I've seen do exactly the opposite....they play up your good days and rate you based on them, which is against the law, but it is a way for them to justify a low-ball rating at the VARO level.

So, in short, be sure to present yourself at your worst and do everything you can to play down your "good" days.