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Dr. Andrew Rynne

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Diagnosed with depressive disorder along with anxiety. What treatment is required?

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Dr. Srikanth Reddy

Psychiatrist

Practicing since :2007

Answered : 2770 Questions

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Posted on Tue, 5 Feb 2013 in Depression
Question: I recently had neuropsychological testing indicating strongly that I am malingering which is not true. The results are devastating and untrue. I scored high on 3 measures for effort/malingering. I am NOT malingering. I have had cognitive deficits. I am going to a hearing for State disability benefits at the end of the month. How do I defend myself?
My diagnosis is MDD recurrent moderate and anxiety d/o NOS, r/o malingering on Axis 1 and on Axis 2 diagnosed as BPD.
How do I best defend myself with the r/o of malingering in an SSDI hearing with a judge, a doctor and voc rehab doctor? I am shocked at my test performance and I have no idea what to do. A friend of mine who is a retired psychologist told me via email that I should go to court and fight it. What happens if they deny me? Will I lose my LT disability from the company I work for?
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Answered by Dr. Srikanth Reddy 8 hours later
Hello,
Thanks for choosing health care magic!
From the description you have given I understand that you have a recurrent depressive disorder along with anxiety issues. I also understand that except for the back pain,you don't seem to be much troubled right now with your psychiatric illness on drugs.
Psychological tests for malingering,although are good, but have a good amount of false positive and false negative results. People who are very anxious about proving their disability, although having a true illness, are also considered as malingerers. While answering the tests you should have been simply truthful (no offense intended!) and not overrate the symptoms in any way as you would have got the benefits with your existing complains.
Now that the issue is in the court you should fight it out and also request for a repeat psychological test for malingering. Its very difficult to prove with certainty that somebody is malingering in the court of law.
Hope I have answered your query. I will be more than happy to help you if you need any further clarifications.
In case you don’t need any further clarifications, you can close the discussion and rate the answer and review it if possible.
Wish you a good health!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Srikanth Reddy 20 minutes later
I am seeing my psychiatrist tomorrow and want to change my sleep meds because I haven't been sleeping and did not sleep the night before the 5 hour testing process. My mental illness culminates in me not wanting to go outside, fear of people, chronic SI (most of the time) severe anxiety, lethargy, poor concentration and memory and lots of anxiety. I've had severe anxiety before and since my almost deadly suicide attempt in Marth 2012 in which I spent 3 days in ICU and 8 days in a psych unit.
No day is simple for me. I have been fighting the depression for a very long time and have a history of 3 inpatient psychiatric admissions over the years and have had ECT. My psychiatrist calls it "intractable depression".
Should I share this with my lawyer whom I see on Friday?
I do plan to continue with the hearing on the 29th and intend to fight it.
I am a therapist myself and am not ready to return to work quite yet. I am not thinking of disability long term especially because I wouldn't be able to live on what the State pays. I am worried about my future and intend to get over this.
Let me know what you think.
XXXXXXX
doctor
Answered by Dr. Srikanth Reddy 10 hours later
Hello XXXXXXX!
Thanks for choosing health care magic for posting your query.
From the description you have given, it surely appears that you have significant depressive symptoms.
You should surely fight as the cause is very much justified. You should share your symptoms details with your lawyer so that he gets to know more from you.
Regarding you treatment, along with an obvious anti depressant, you can ask your doctor to consider the use of lamotrigine or lithium or valproate. Also quetipine is a also quite effective in such cases.
I am sure you are considering CBT and psychodynamic psychotherapy for your illness (being a therapist).
Unfortunately we are not allowed to prescribe medications on this site as it will be a violation of the law.
But you should go ahead with the case.
Hope I have answered your query. I will be more than happy to help you if you need any further clarifications.
In case you don’t need any further clarifications, you can close the discussion and rate the answer and review it if possible.
Wish you a good health!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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