How to unpick what the issue is?

[herewegoroundthebastardbush]

I have recently requested treatment for Binge Eating Disorder. Waiting list, obviously. So reading around in the meantime.

Already suspect I have ADHD. But also now checking boxes for PTSD and BPD/EUPD. Have also been treated for depression in the past.

For a start, I'm wondering if this is like horoscopes - if you read the lists of symptoms expecting to find a match you will find one. For another, I'm wondering how you identify 'which' is your real problem when so many seem to have overlapping symptoms.

I got to thinking about this as I saw someone on the 'lightbulb' thread on AIBU say that getting medicated for their ADHD cured their BED overnight. And thought, am i about to embark on a long wait and then a difficult course of mental health treatment for BED, when potentially the issue is actually ADHD and the BED is a symptom of that? Or is it that I actually have BPD/EUPD, and what looks like ADHD is just that?

This matters because in my experience there is no 'exploratory' treatment for mental health issues available - you pretty much have to go into a GP appt knowing what problem is, what treatment you want to pursue and ideally tell them which service you want to be referred to/medication you would like to be put onto. I have never presented to a GP with a problem, just the problem, and come away with a plan or course of treatment. They ask "what are you hoping to leave this appt with" and I have to literally say 'a scrip for 20mg citalopram' or 'a referral to the eating disorders service' for anything to actually happen. Basically I am expected to diagnose and treat myself, and they are just an authorising service.

But I have no expertise and am worried about my own bias when looking at my issues.

How do you actually unpick this (in the absence of concerted professional help)? Is this something the ED service will work through with me when I reach the top of the waiting list? Or will they just treat the ED as a discreet illness rather than identifying causes/comorbidities?

I wish I knew the answer to this. I totally agree with what you say about there being no exploratory work and being expected to diagnose yourself and also request what you want. I can’t imagine this happening in any other area of medicine.

In many way this is not actually surprising as mental health is fairly poorly understood by many GPs and the whole system is a bit box-ticky.

Can you ask to be referred for exploratory talking therapy? Although appreciate that wouldn’t yield a diagnosis.

Or, if you can possibly afford either private therapy or private psychiatrist appointment then that could be another option.

You could also say to your GP what you’ve said in your OP and ask them the question.

Good luck. Navigating all of this is tough but you’ll get there.

Have you ever read 'Why Has Nobody Told Me This Before '? (or something like that!) It's by a psychologist and it has really clear information about different mental health symptoms, rather than gathering symptoms into arbitrary 'conditions'. 'Cracked' is also interesting on the history of the DSM, and why diagnoses are not always helpful...

Book

I have BED, OCD and Health Anxiety. BED has been under control for some time now, and naturally there are links with my OCD and perfectionism, anxiety traits etc. I think the likelihood is it’s all interwoven, but ultimately I have never had treatment for BED, it was my other therapies that sorted that out. BED was a symptom rather than a cause so that makes sense. Ultimately it depends on you, you’re not a computer, you’re an individual and it depends what it stems from.

Also IME, BED is treated with CBT which doesn’t work for me. I need to know the core issue, where it came from and understand it and have empathy for myself to let it get better. But different people have different thoughts around that.