Reply to Why are people more sympathetic to Lindsay Clancy than Andrea Yates? (Child death mentioned)

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]I don't understand how she was not diagnosed with postpartum depression or anxiety, yet she had suicidal ideation and an infant at home. [b]What ruled it out as PPD/PPA and made it GAD instead? [/b]Also, she had a terrible reaction to zoloft. [b]SSRIs can trigger mania and even psychosis in people with bipolar disorder.[/b] At any rate, her mental health sounds complicated and ambiguous. I made the mistake of watching the arraignment.[/quote]

Providers make mistakes. Sometimes a lot of them. [/quote]

Where did you see she had bipolar disorder? [/quote]

DP here. The only official medical diagnosis that has so far been released is GAD. (Generalized Anxiety Disorder.) She herself referred to it as anxiety in Social media posts. [/quote]

That's right. But as everyone here who has been through serious mental health problems--our own or those of family members--knows, it is not uncommon for a psychiatric illness to have what is effectively a prodromal phase, where some symptoms are present and it looks like one thing, and then a full-blown phase, where many more symptoms are present and it's clear what is or is not wrong. Some people are psychiatric patients for decades with diagnoses that are not perfectly clear and medication histories that match that.

People want to believe that diagnosing mental illness is a straight one in column A, any three out of these seven in column B thing. The DSM is written that way. But if you talk to providers who are conscientious, they will all tell you that the DSM is not the Gospel. It is psychiatrists' best collective effort at characterizing various states of psychiatric illness and health. Actual patients exist outside the boundaries of those efforts pretty frequently.

So: she could have had PPD or PPA that she hid (because it's stigmatized! which promotes hiding) and become psychotic in the course of that.

But PP is also, with reason, raising the question of whether she might be a person who is bipolar, whose initial symptoms were activated rather than depressed (looking more like generalized anxiety, less like mania), and who had deterioration triggered by medications that are often (NOT ALWAYS) a poor fit for people with bipolar disorder. [/quote]

Yes to the above. I'm the PP from the original post who was confused about her diagnosis of GAD and the statement that she did not meet criteria for PPA/PPD despite having a young infant. I have a family member who took years to get correct diagnosis and treatment for BD I. Years of manic episodes were treated as anxiety and made dangerously worse by an SSRI and Xanax. It took a severe psychotic break to finally get the appropriate diagnosis and treatment.[/quote]

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