Okay. The psych community as a whole is seriously flawed in many ways {as much as they'd like to think they're not super flawed, they are} but right now I'm just gonna talk about their horrible process of screening for mental illness.

I understand that you can't really screen for EVERY single mental illness since there's just too many, but I do think they should screen better for mental illness. Whenever I see a new therapist, even though I've had 2 separate people diagnose me with bipolar I with psychotic features {one even from their own fucking agency} they put me through this shitty screening process that takes like 4-6 hours {I'm not exaggerating, they'll usually do these appointments in the afternoon and it's done by like 6 PM} and it accomplishes nothing. It's protocol so even with a diagnosis I can't skip it, which I understand. The material in it though seriously needs to be changed.

They only screen for depression, anxiety, PTSD, ADHD, and they BRIEFLY delve into anorexia. That's... really not a lot of coverage. The majority of the appointment is passing paperwork that has nothing to do with the screenings, so I think they should separate this appointment into 2 different ones: one for paperwork and the other for screenings. I understand the screenings are also part of their paperwork, but they need to do more screenings and since these appointments are already so long due to unrelated paperwork, I think it should be put into two appointments so they can do more screenings without making it a like... 8 hour appointment or something. I can't think of anyone who'd want to sit through an 8 hour appointment. Already, 4 hours is REALLY long.

How do they screen? Well, they give you these little surveys with each paper screening for a different illness. On the PTSD screening there's two sides, one asking if you've experienced any traumatic event {they have a huge checklist of traumas and then they have an option for something they didn't list} and then it tells you that if any of the boxes are filled in to turn it over and do the back, which has questions related to PTSD like if you've felt on edge for the past month.

The rest of the screenings are just one page and ask you questions related to the specific illness. For example, the anxiety test might ask for the past 6 months if you've felt really fidgety or had lots of stomach problems and the depression one might ask for the past 2 weeks if you've felt really sad and empty. At the bottom they then ask how much the symptoms have caused problems in your daily functioning, but they basically ignore whatever you answer there.

I remember at my last screening I apparently scored in the highest possible category for anxiety {based on your score they categorize it between no illness, mild severity, moderate severity, and severe}, but even though I scored so high on my anxiety screening I answered that it didn't really bother me because it didn't. My therapist didn't care though and gave me anxiety counseling for an illness I didn't even have. Yes, I worry a lot, but it doesn't usually bother me. If it is bothering me, it's not anxiety, it's paranoia.

How do I know it's not anxiety? Because the fears that bother me aren't based on what's going on in my life, they're more delusional-like fears {like fearing that I'm being followed everywhere or that someone might be reading my thoughts- another common one I have is that all my online friends are actually just my dad or someone else I know IRL with like 20 accounts}. I know it's not real so it's not a delusion, but the idea scares me so it's paranoia. Thoughts I have that are grounded in reality {like fearing I might fail an upcoming test} that give me anxiety do make it a little difficult for me, but despite me experiencing them so chronically I have really good coping strategies in place so they just don't get to me that much. I don't have an anxiety disorder, I have paranoia as a symptom of my bipolar.

I also scored moderate {just a couple points from severe} on my PTSD test too even though I answered it doesn't bother me at all whatsoever. Yes, I think about my rape a lot- actually, the event VERY frequently crosses my mind, but it doesn't bring me anxiety to remember it. Actually, sometimes I start making jokes about it and laughing my ass off from my own jokes. It's not done as a coping mechanism, I just laugh at everything and anything I can. Doesn't mean I find it funny or I'm trying to cope with it, I'm just making a joke. Part of PTSD is that the event frequently replays in your head, but the most important part is that remembering it gives you REALLY great agitation. Clearly if I'm comfortable enough to say, "Haha virginity go brrrr," I don't think I'm really traumatized by it anymore. There was a point in time I was, but not anymore.

In mania, I'll usually score really high on ADHD screenings but answer that it doesn't bother me. Guess what? It's not ADHD, it's mania. I score really high in terms of hyperactivity, but as far as the attention deficit part goes, I'm the complete opposite. I don't hyperfocus all the time, but I'm usually pretty damn engaged in whatever I'm doing.

In depression, well... obviously I score high on depression tests LOL {and answer that it's so crippling I can't function as a member of society}. Bipolar depression is identical to unipolar depression, the only difference is we also experience manic episodes. So... I guess it's kind of accurate, except if I didn't tell whoever was screening me that I'm bipolar, they'd think I only had depression.

You see the issue here? Not only do a lot of problems I DON'T have {but my personality may slightly mimic} I score high for because the quality of the screenings suck, but a lot of my bipolar symptoms will cause me to score high in other screenings. I'm aware they don't intend to diagnose right off the screenings, but they are meant as a tool to let the therapist know what they might be dealing with. I don't wanna have to waste my first real appointment convincing a therapist I don't have anxiety and PTSD and it's just that their screenings suck that they thought they had to look into it further when they really don't.

They don't have any sort of binge eating, bulemia, bipolar, schizophrenia, OCD, etc. screenings. They might have some for personality disorders, but those can only be diagnosed when you're 18 so obviously a therapist isn't going to screen me for them because I'm only 16 at the time I'm writing this.

I'm aware that every agency is different and some might do a MUCH better and thorough job at screening, but with the agency therapists keep tossing me around in {first one I stopped seeing because we thought it was just depression, second one moved to another state, third one I'm forever stuck in limbo with since COVID had to halt our appointments back in like March and I've never heard anything since} the system sucks.

The only reason any of them believe me when I tell them I'm bipolar is because someone in their own agency AND someone who works at a mental facility run by a different agency diagnosed me, and even they were reluctant to do it because, "You're so young, it's probably just depression because bipolar is so rare in someone your age."

Well, someone's gotta be the statistic and it happened to be me. Rare means you will still see it, and for the people who fall under 'rare,' they usually end up with very unfortunate turnouts. It takes an average of SEVEN YEARS before someone with bipolar disorder {at any age} will get properly diagnosed because therapists will just assume it's 'another depressed patient.'

Usually, therapists will only diagnose a patient with bipolar if the patient ends up making an offhand, casual comment about something mania-related that they didn't even know was relevant. I only knew my manic symptoms were relevant because I knew what bipolar disorder was, and I realized that it sounded exactly like me. Even then, I had to heavily advocate for myself to get a screening and they only did it to shut me up so they could tell me I wasn't bipolar. Surprise motherfucker, you made the diagnosis a few days later.

And how about other mental illnesses like schizophrenia? That's extremely rare and I can't even imagine how difficult it would be for someone to get a proper diagnosis. While it is true that the symptoms are technically more obvious {considering paranoia, hallucinations, delusions, frenzied/impaired/jumbled speech/thoughts/behavior, and other symptoms are a hallmark of schizophrenia}, people suffering from schizophrenia aren't always eager to share their experiences which can easily make a therapist mistake them with having depression {since a lot of symptoms of schizophrenia are pretty similar to depression}.

What about bulemia? It can easily get mistaken for binge eating since a patient might hear about binge eating disorder after being diagnosed with it and think that's what they have. They might think them puking their food back up is irrelevant because everything else they experience is pretty much described, and unless they knew bulemia existed they'd just assume the therapist did their job and got the right diagnosis.

What about OCD? If the therapist only does an anxiety screening, OCD can get easily misdiagnosed.

There's all sorts of other things that can easily get misdiagnosed and it's entirely the therapist's fault. Patients don't usually know what is and isn't relevant to their illness because most patients aren't properly educated or they don't wanna get in their therapist's way. If therapists are only asking if patients experience GAD symptoms, they're missing the fact that it could be an entirely different kind of anxiety. There should be an anxiety screening, but if their screening shows anxiety then ask about other things than JUST anxiety. Ask about panic disorder, ask about social anxiety, ask about OCD!

Just because a patient shows on their screening they might have depression doesn't mean they do. Therapists need to ask follow-up questions, like if they hallucinate or if they go through periods of having high energy. They shouldn't just ask follow-up questions ONLY related to depression because it could be something that mimics depression but also presents with other symptoms, but they won't know until they ask.

Most of the time, it wouldn't surprise me if those extra questions come back with nothing. But you know what? For the people with rare mental illnesses, it'll help them get help sooner. The longer a mental illness goes without being properly diagnosed and treated, the worse it tends to get.

I'm kind of lucky because even though it's been months since I've seen my therapist, I haven't totally flown off the rails. There's been plenty of periods of time where things got really questionable, but I've been able to mostly live a semi-contained life. Another big part is that I've mostly been in mania {except for May and June, we don't talk about those months}, so just by luck I've been mostly pretty happy. I know when I hit depression {or if I end up going into some REALLY bad mania- my manic episodes are usually productive but there are times it was more harmful than good} I am not gonna just be chillin' casually.