Guidance for adjustment disorder w/ anxiety

SoTex08

PEB Forum Regular Member
Registered Member
Hello all, hopefully I can find some guidance as to what I should do. I've been seeing BH for the past 3.5 years. Since then, I have seen 4 different providers (currently seeing 2- one civ and one officer). I have been prescribed several different medications- all of which have helped to take the edge off, but I feel that I am on the edge of breaking down at times. I really feel like it's only a matter of time before it starts to affect my work and home life (it already slightly affects work, but luckily my NCOIC is aware of what I'm going through and allows me to cool down when necessary). With that being said, am I able to request a MEB? I am not sure of the process, so forgive me if I am asking stupid questions. It just seems like I've been strung along this whole time and I don't know where else to go. I've got just over 2 years left on my second contract and I feel like the Army could use someone else at a full capacity rather than me since I'm pretty much just taking up time and money. Thanks in advance.
 
No, you cannot request your doctors must refer you the longer you stay in treatment and taking meds the more likely they will say you are fit and your conditions are controlled by medications especially since you have stated it has affected your home or work life yet.
 
SoTex08- ALL- I would humbly recommend you see the following PEB Forum Thread: “Disagreement on diagnosis” at Forums PEB and Disability Evaluation System Overview Conditions and Ratings PTSD and Mental Health Conditions by Thread starter Crimes&Mercies Start date Sep 17, 2018

From above post: chaplaincharlie stated “Generally speaking, if the C&P examiner finds a MH disorder, it matters little which disorder he/she finds in terms of compensation. The amount of compensation is based on occupational and social impairment
For treatment purposes an accurate diagnosis is essential. But that is not related to compensation.”

Furthermore, I would encourage you to look up Adjustment Disorder, in DSMV and other sources. Due to time, I have attached the below link to Wikipedia- which in many academic/professional circles is not considered “authoritative”- but can get one started:

Adjustment disorderFrom Wikipedia, the free encyclopedia; accessed on 30 SEP 2018 appx. 0012 AM EDT, for example at web-address: https://en.wikipedia.org/wiki/Adjustment_disorder the below in “italics” is copied from above cited Wikipedia article/ web-address:

Diagnosis The basis of the diagnosis is the presence of a precipitating stressor and a clinical evaluation of the possibility of symptom resolution on removal of the stressor due to the limitations in the criteria for diagnosing AD. In addition, the diagnosis of AD is less clear when patients are exposed to stressors long-term, because this type of exposure is associated with AD and major depressive disorder (MDD) and generalized anxiety disorder (GAD).[12]
Some signs and criteria used to establish a diagnosis are important. First, the symptoms must clearly follow a stressor. The symptoms should be more severe than would be expected. There should not appear to be other underlying disorders. The symptoms that are present are not part of a normal grieving for the death of family member or other loved one.[13]
Adjustment disorders have the ability to be self-limiting. Within five years of when they are originally diagnosed, approximately 20%–50% of the sufferers go on to be diagnosed with psychiatric disorders that are more serious.[2]

ICD 10 classification International Statistical Classification of Diseases and Related Health Problems, mostly known as "ICD", assigns codes to classify diseases, symptoms, complaints, social behaviors, injuries, and such medical-related findings.
ICD 10 classifies adjustment disorders under F40-F48 and under neurotic, stress-related and somatoform disorders.[14]


Furthermore, think one should also be advised of the following- once again from above cited Wikipedia article “quoted” in “italics” below:

“Criticism Like many of the items in the DSM, adjustment disorder receives criticism from a minority of the professional community as well as those in semi-related professions outside the health-care field. First, there has been criticism of its classification. It has been criticized for its lack of specificity of symptoms, behavioral parameters, and close links with environmental factors. Relatively little research has been done on this condition.[15]
Adjustment disorder has been described as being so "vague and all-encompassing… as to be useless,"[19][unreliable medical source?][20] but it has been retained in the DSM-IV and DSM-5 because of the belief that it serves a useful clinical purpose for clinicians seeking a temporary, mild, non-stigmatizing label, particularly for patients who need a diagnosis for insurance coverage of therapy.[full citation needed]

In the US military there has been concern about its diagnosis in active duty military personnel.[21]

Back to ChaplainCharlie: “For treatment purposes an accurate diagnosis is essential. But that is not related to compensation.” IMO- this is a major concern all “VETERANS” should be aware of and highly “cautious” of as can in fact create many issues especially when “dealing” with civilian authorities and even the US DVA as they will not- in most cases go by what one’s “treating” providers in fact say, but with what one is in fact “compensated” for and can in fact cause more than serious issues…… that can in fact “completely” ruin a “Veteran” and their “families” lives…… Additionally, IAW Wikipedia, AD is suppose to most likely self-resolve over time and proper “psychotherapy” and can in fact “mask” “delayed” onset of PTSD due to combat service, etc…..

Not making any recommendations here, as one simply needs-IMO- to educate one’s self on whatever it is one is “diagnosed with” particularly if “multiple” physicians, and in particular the US DVA and US Military are NOT in “agreement with each other”- that alone should be a “major” RED FLAG to any VETERAN and their Family, and prompt a whole lot of “questioning” …… as well as “research” into one’s own conditions so, hopefully, they can ask the “hard” questions” of their providers…..

Hopefully, this assist’s……………………………………………?????

PS: Food for thought, might want to look into-IMO-

Modern Man in Search of a Soul” From Wikipedia, the free encyclopedia; at web-address: https://en.wikipedia.org/wiki/Modern_Man_in_Search_of_a_Soul

https://archive.org/details/in.ernet.dli.2015.218430/page/n7 - Modern Man In Search Of A Soul by C G Jung Publication date 1933 Topics Salar Collection digitallibraryindia; texts Language English Book Source: Digital Library of India Item 2015.218430

Still having issues this web-site- anyone else????
 
When a member ask a provider to start an MEB, they often get labeled as malingering. What you can do is have a frank talk with your military provider. What you wrote above is a good outline for that talk:

I have been in treatment for 3.5 years with 4 providers.
I still feel like I am on the edge of breaking down.
I do sometimes breakdown, fortunately my NCOIC understand and gives me some space when needed
I am concerned my next NCOIC will not be as understanding.
I am concerned that I'm always on the edge and some time over the edge.
What do you suggest?

No demands, just lay out the facts and put the future in your military provider's lap.
 
SoTex08- I believe, ChaplainCharlie has a somewhat valid point: "When a member ask a provider to start an MEB, they often get labeled as malingering!" Furthermore, per Adjustment disorderFrom Wikipedia, the free encyclopedia; accessed on 30 SEP 2018 appx. 0012 AM EDT, for example at web-address: https://en.wikipedia.org/wiki/Adjustment_disorder the below in “italics” is copied from above cited Wikipedia article/ web-address: and as cited above and below from said/cited Wikipedia article

“Criticism Like many of the items in the DSM, adjustment disorder receives criticism from a minority of the professional community as well as those in semi-related professions outside the health-care field. First, there has been criticism of its classification. It has been criticized for its lack of specificity of symptoms, behavioral parameters, and close links with environmental factors. Relatively little research has been done on this condition.[15]
Adjustment disorder has been described as being so "vague and all-encompassing… as to be useless,"[19][unreliable medical source?][20] but it has been retained in the DSM-IV and DSM-5 because of the belief that it serves a useful clinical purpose for clinicians seeking a temporary, mild, non-stigmatizing label, particularly for patients who need a diagnosis for insurance coverage of therapy.[full citation needed]

In the US military there has been concern about its diagnosis in active duty military personnel.[21]

I am pretty sure it will also have to do with a "proper" diagnosis, as well as "causality." time in service etc... as we are all human and certain "conditions" and circumstances in fact "perceptually" play a role especially with one's chain of command....

Take for example, and US Army helicopter pilot, whom was shot down as well as shot, not only in Afghanistan but in Iraq as well, and had resultant Chronic PTSD....after awhile... i.e. "delayed onset" and medications they were on "proved" not only a hazard to flying, but also their "confidence" more than likely was totally "shot".... In this instance, most likely the Chain of Command made every effort to "retain" the individual/pilot, get them proper care for PTSD, but in the end- issues were in fact to great, and "pilot" themselves was in fact "afraid" to fly and perhaps not only re-injure themselves, but their aircraft and air-crew as well.....

I think one, would simply agree, that in the case of this "generic" pilot, they had in fact gone above and beyond the call of duty, and no-one was going to question their "diagnosis" nor decisions, especially regarding pilot, crew, and aircraft safety, ..... at least in no-one in their "right" minds..... i.e. all boils down to "circumstances"......and in a lot of cases "perception"... whether it be correct or incorrect "perception"....

So, with something like AD- and other more serious potential "issues" down the road- if one has been diagnoised with this, especially, upon return from a "combat" tour, and in fact their is "disagreement" among "medical" professional's, I think in part ChaplainCharlie may be correct, but would in fact first - IMO- concentrate on a correct "diagnosis" or at least "getting" all medical entities on board as to an "agreed" upon diagnosis before trying to "push" for an MEB, either outright or "round-about"...... IMO

Hope this helps......SoTex08.....???????
 
SoTex08- could not edit above as forgot something as well.... in case of "generic" pilot above- think it is also pretty safe to say "no one" was going to- from offshoot- AD perhaps- try and "diagnose" them "personality disorder, bi-polar, schizo-effective...etc...." which, IAW above cited Wikipedia article, etc... is possible with AD- as it appears the US DVA and other's, per numerous "media" articles as well as numerous other Threads/Post's here indicate by "veterans", simply likes to try and do.....IMO- which goes back to a correct "diagnosis" - agreed by most all "providers" is perhaps the most important issue as well as "circumstances"..... i.e. "line of duty"- "combat related" - "instrument of training for war" etc......

Furthermore, one could take host other example's of "unseen" wounds such as a "soldier" blown-up countless times- but no physical wounds- to point caused "significant" enough TBI, etc.. that chain of command noticed, and actually "pulled" soldier out of formation for "evaluation" against their wishes.... and it was in fact, via extensive testing, discovered this soldier had "numerous" unseen severe "medical" issues...... resultant to exposure "numerous" close "explosive" blasts......

Something, to simply consider, perhaps, and once again hope "helpful" SoTex08.......????????

Still issues this web-site...................................????????
 
This is all excellent information. Thank you all for providing your input. It looks like I have some research to do and just sit down with the provider and lay down the facts. Hopefully this approach will allow me to get some answers from them.
 
No, you cannot request your doctors must refer you the longer you stay in treatment and taking meds the more likely they will say you are fit and your conditions are controlled by medications especially since you have stated it has affected your home or work life yet.
For "real life purposes" this is mostly right about how you get to an MEB and PEB. However, your commander can request a fit for duty determination (AR 600-200, Army Command Policy), and the Commander, HRC, can also request (really direct) an MEB and PEB.
 
I spoke with the BH provider and was told that I would be PCSing despite my ongoing issues. They pretty much ignored my symptoms and told me that I could continue BH treatment where I'm going and if it gets worse, I will/could be medboarded. I'm at a complete loss as to what I should do. My symptoms havent gotten better despite several medications and I'm concerned that I won't be able to perform at the level that is expected of me. I'm sick of dealing with anxiety and I feel like I was just thrown aside and expected "just to deal with it". Wouldn't continuity in BH treatment be better than going somewhere else and starting over? At what point is someone expected to deal with this stuff on a daily basis? Should I be doing nothing at work in order for them to do something? In the meantime they gave me a temp profile, a refill of meds, and told me good luck.
 
So Tex08, This was written on my P-3 profile. The Soldier is currently in MEB process. No access to weapons/ammunition. The Soldier should have access to all Behavioral Health appointments. No alcohol use. Alcohol can worsen BHconditions and interfere with medication(s). Ensure the opportunity for eight consecutive hours of sleep every 24 hour period for the duration of the profile to maximize recovery. Notify the profiling officer immediately if there is a sudden deterioration of performance or fluctuating behavior. No deployments to an austere environment. No PCS, TDY, or ETS until final fitness for duty determination. This Soldier should not be issued an individually assigned military weapon, attend any live fire drills, ranges, or participate in combat simulation events.
 
How much did your diagnosis effect work performance before they initiated it? I'll be honest, I would like to just fulfill my obligation and ETS rather than be medboarded, but not if my symptoms continue like this. I'm getting sick of the anxiety that is constantly triggered for no reason. I'm drained all the time and it has really taken ahold of my focus through daily routines- whether I'm at work or not.
 
It effected my family life more often than my work. I was med boarding as a reservist. My symptoms was dated back in 2004. I was prescribed Lexapro back in 2005.

In 2008 was s the first time going through the MEB process. I knew nothing about being MEB boarded. I thought that the Army was just trying to put me out, so, I fought it.

I started seeking treatment in 2015 with the VA. And that's when I realized what I was dealing with.

During my PHA in 2015 I told them the problems that I was having . 2016 I received two 90 days temp profile before it became permanent in July 2016. After that is when the journey began. I say this to say that. It can be a grueling process at times.
 
It effected my family life more often than my work. I was med boarding as a reservist. My symptoms was dated back in 2004. I was prescribed Lexapro back in 2005.

In 2008 was s the first time going through the MEB process. I knew nothing about being MEB boarded. I thought that the Army was just trying to put me out, so, I fought it.

I started seeking treatment in 2015 with the VA. And that's when I realized what I was dealing with.

During my PHA in 2015 I told them the problems that I was having . 2016 I received two 90 days temp profile before it became permanent in July 2016. After that is when the journey began. I say this to say that. It can be a grueling process at times.

Well I hope that your situation is better now. Thanks for the information.
 
I did get medically retired, but I am still dealing with my MDD/Anxiety Disorder NOS. I am continuing with my treatment with the VA. Every chance I get, I try to do either individual counseling or group sessions. I hope that everything works out for you my friend.
 
I did get medically retired, but I am still dealing with my MDD/Anxiety Disorder NOS. I am continuing with my treatment with the VA. Every chance I get, I try to do either individual counseling or group sessions. I hope that everything works out for you my friend.
Thank you and same to you!
 
This is all excellent information. Thank you all for providing your input. It looks like I have some research to do and just sit down with the provider and lay down the facts. Hopefully this approach will allow me to get some answers from them.

SoTex08-ALL- glad found input from all useful. However, would caution, not only you, but everyone, it is "good" to "get smart" on your conditions and play "devils" advocate with- especially- MH Providers... however this could somewhat "upset" some and might end up with something like "minimal-to no insight" into conditio(s) which one simply does not want to incur for very severe "civil" ramifications. One simply wants a fair to good "insight" rating, as per US DVA Providers, etc...- will most never likely get an above "good" rating on this......

Furthermore, if MH Provider either unwilling answer "stump-the-chump" (so to speak) questions and/or get back if do not know answer- as only human- then PERHAPS need ask "question" "Is this the MH Provider for me...????"

PS: Food for thought only perhaps:

Carl Jung- "The Undiscovered Self" at for example only web-addresses: https://fleurmach.files.wordpress.com/2016/07/jung-the-undiscovered-self-1957.pdf and/or https://www.barnesandnoble.com/w/the-undiscovered-self-carl-g-jung/1116803336?ean=9780451217325#/

SoTex08-ALL- hope helps.....

Still issues this website>>>>>>>>>>
 
Quick update: at some point in time the behavioral health officer that I am seeing has communicated to my command that I just want to get out. With this misinformation being out in the open, I will be speaking to the commander. I'm not sure how to explain my situation. I want to finish my obligation, but I feel that I'm not mentally prepared to serve an Unaccompanied OCONUS PCS without the risk of resetting the progress that I have made. Would explaining it like this be viewed in a negative manner? I don't want to shoot myself in the foot here, but I also don't want to deal with the BH issues that come with being dropped somewhere by myself; with a command that is unfamiliar with my history.
 
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