Pseudo Dementia

[cognitivelykaput]

After having experienced progressive cognitive decline over the past ten months, coupled with all manner of random shooting pains, blurred vision, muscle twitching, movement issues, etc, I've now been told by two different neurologists in the past month, I'm suffering from some sort of pseudo dementia / severe somatisation disorder.

As  previously, perfectly healthy 35 year old male, I find this very hard to accept, but have now had so many different opinions this year, all alluding to the same diagnosis, two normal MRI scans of the brain, innumerable blood tests, etc, I guess I'm just going to have to go with it.

My question is, how is something like pseudo dementia treated?

[whodunnit]

Hi again,

I'm afraid those of us trying to reply are in the dark as indeed Cog did not give much detail to start and could never give us enough detail for so many specialists and docs to diagnose, not guess, the same thing.

You've had opinions galore Cog and it is time to listen to the docs.

They do not just follow the previous docs opinion. Except perhaps when you've already had 6 opinions already, all basically agreeing. They do need the background information from your doc to even make a start on a diagnosis and any other opinions are helpful. Not something to copy. They are all very litigation conscious and would do their job properly. To say they copy is bordering on a conspiracy theory and is rather odd.

Sure we deny illnesses, all the time, I did it for 25 years. But not once I had a diagnosis from a specialist. Until then I just denied it to myself.

To Mammo, I truly do not see how you can make such a firm statement about what the illness is in opposition to 4 neurologists and all the rest of the docs. To make that statement is rash and silly.

If you look up this illness it basically says it is a secondary illness initiated by depression and the treatment is with anti depressants etc, as for depression. It appears to read that by treating the depression the secondary illness is treated.

So it is not misdiagnosed at all. It appears to be a real illness co dependant with depression and treated in the same way. But it is still the correct diagnosis.

I think we should all note that Cog has stated he had NO PREVIOUS history of depression whatsoever. So there is no connection as for most of us with long histories.

Additionally none of the doco I found said much if anything about this illness for anyone other than elderly.

With no depression background and no real research on people as young as Cod I think any of us would be totally unable to even venture a guess as to what it is or what to do.

How on earth can we know any better than the number of specialists who've seen, felt, talked to and tested this young man?

Cog, stick with the doctors and start listening as saying they are all wrong is not helpful to you or any treatment. I gather you have not had treatment as yet as you are asking what treatment is relevant. Is that right or have you not told us about that?

We are not here to compete for who can research the best. What we can do is nothing compared to the training these specialists get. And so many, all in general agreement. Unless there is a real conspiracy the diagnosis is correct. Time for treatment.

I must state I know nothing of this illness other than what I've read in the last few hours and do not make any claims to knowledge of it. Specialists have such a right.

[Jaquta]

People when they post don't disclose every symptoms they have.
I personally probably wouldn't be in a huge hurry to tell a forum I experienced sexual dysfunction or was constipated or had diarrhea (especially if I thought I had a brain tumor or some other major neurological condition which all seems totally unrelated).

Does he really not show signs of cognitive impairment?  He says he does.
No one is saying that he is demented -just that his symptoms are temporary.

It would also be foolish of him not to be receptive to so many different specialist opinions.  Yes, if he's not happy he needs to follow things up but he shouldn't do that at the exclusion of other diagnoses he's been given.  He at least needs to consider them.

He isn't accepting the doctor's DIAGNOSES (not guesses).  I think he just feels powerless to pursue it further.

I don't think he is depressed, more defeated (which probably amounts to being depressed).
You mean he is too old.  Didn't you write symptoms beginning before age 30??
Are any of us too young to have any of our issues?  Depression made me feel dumb and I was barely out of my teens.  Should that have meant I couldn't be depressed and have symptoms mimicking dementia?  Mental illnesses don't discriminate.  It doesn't matter about age, gender, ethnicity, religion, etc.

Depression doesn't always CAUSE dementia like symptoms or somatization.

I have a theory that the answer lies in what happened in December '08.
(December?  Isn't that a hugely stressful or depressing time for many people?)

Conversion disorder has neurological symptoms too.  It's interesting reading if nothing else.

I expect you would treat the pseudo dementia by treating the somatization disorder.  Try googling them or looking up wikipedia.

[mammo]

The treatment for what you have are anti-depressants and therapy. Why are you so willing to accept the doctor's guesses, and not even consider depression?  You are too young to have what they are saying and you admit to being depressed at one time.  How can you be sure that you still aren't?  Just look at the facts, and seek psychiatric help before enduring more tests. You are allowing your body to deteriorate, why? Why would you not consider depression when everything that's written on what they are saying you have states that it is always depresssion causing your symptoms. Are you afraid of what you might learn?  Don't be foolish about this, consider it all and don't go down without a fight!!!!

[mammo]

What he has been diagnosed with is often misdiagnosed and is actually severe depression.
  
Somatization Disorder
SYMPTOMS
A history of many physical complaints beginning before age 30 years that occur over a period of several years and result in treatment being sought or significant impairment in social, occupational, or other important areas of functioning.
Each of the following criteria must have been met, with individual symptoms occurring at any time during the course of the disturbance:

four pain symptoms: a history of pain related to at least four different sites or functions (e.g., head, abdomen, back, joints, extremities, chest, rectum, during menstruation, during sexual intercourse, or during urination)


two gastrointestinal symptoms: a history of at least two gastrointestinal symptoms other than pain (e.g., nausea, bloating, vomiting other than during pregnancy, diarrhea, or intolerance of several different foods)


one sexual symptom: a history of at least one sexual or reproductive symptom other than pain (e.g., sexual indifference, erectile or ejaculatory dysfunction, irregular menses, excessive menstrual bleeding, vomiting throughout pregnancy)

one psuedoneurological symptom: a history of at least one symptom or deficit suggesting a neurological condition not limited to pain (conversion symptoms such as impaired coordination or balance, paralysis or localized weakness, difficulty swallowing or lump in throat, aphonia, urinary retention, hallucinations, loss of touch or pain sensation, double vision, blindness, deafness, seizures; dissociative symptoms such as amnesia; or loss of consciousness other than fainting)

He does not have enough symptoms for either thing they are guessing he has.  It would be foolish for him to accept their diagnosis.

[whodunnit]

I note you have stated 2 neurologists have given you almost identical diagnoses. You also say all other opinions etc over the last year all also allude to the same diagnosis.

Your question was how is this diagnosis treated.

Really a question only for a doc or even a specialist as none of us is so qualified.

I too have had long term problems with getting a diagnosis on a particular problem. But the difference was all my testing and opinions said "I don't really know and can't identify anything". This is a typical response to many of our, depressed, ailments I'm afraid.

But, in your case they have been quite specific and you seem to have accepted it. Which is best as they are all saying the same thing. Right?

I also must point out that the symptoms you record are not listed as depression symptoms, nor have you suggested they are. I see no reason to doubt the diagnosis and hope your doc can advise best on treatment. Googling the question would seem more productive too.

Last thing I will say is that any bad news diagnosis is more than difficult to accept and those of us here are no exceptions. Depression is probably one of the most denied illnesses despite diagnosis and evidence so we are not good examples of how to deal with a diagnosis.

[mammo]

After researching this I do think you need to take a close look at yourself and your life.  Often this can be caused by post traumatic syndrome (which you may not even remember), and the list goes on and on.  Often we don't know we're depressed and this may be the case with you.  Every article leads to depression, and the sooner it is treated as such, the better the recovery.  Your "tremendous anxiety" may have ballooned with this, but I'm betting it was there before also.  You may not have ever recovered from the break-up that had you depressed earlier.  You should really try therapy and an anti-dpressant medication before enduring further testing.