1011-Preventing Misdiagnosis in Counseling _ Holistic Health

Counselor Toolbox Podcast with DocSnipes

Introduction

Differential Diagnosis Overview

• Symptom Overlap: Many symptoms, like fatigue, can have multiple causes (e.g., hormonal imbalances, medication side effects, nutrient deficiencies).
• Comprehensive Approach: Importance of considering bio-psycho-social factors before diagnosing to avoid missing underlying physical causes.
• Talk Therapy Limitations: Emphasizes that some conditions (e.g., atrial fibrillation) cannot be resolved through therapy alone.

Framing Bias in Diagnosis

• Definition: A cognitive bias where decision-making is influenced by how information is presented.
• Impact: Patients may describe symptoms differently to different professionals (e.g., physical symptoms to doctors, emotional symptoms to therapists), leading to potential misdiagnoses.

Confirmation Bias

• Definition: The tendency to favor information that confirms pre-existing beliefs or expectations.
• Clinical Implications: Can lead to misdiagnoses by assuming a patient’s issues are solely mental health-related without considering physiological causes.

Availability Heuristic

• Definition: A mental shortcut where people rely on immediate examples that come to mind.
• Example: Increased diagnoses of personality disorders due to media coverage, potentially leading to over-diagnosis.

Importance of Comprehensive Evaluation

• Holistic Approach: Evaluate all aspects of a patient's life (physical, emotional, cognitive, etc.) to determine the root cause of symptoms.
• Avoiding Over-Diagnosis: Caution against diagnosing multiple disorders when symptoms might be better explained by a single condition (e.g., CPTSD).

Physiological Causes of Depression

• Hormonal Imbalances: Low testosterone, estrogen, thyroid issues.
• Nutrient Deficiencies: Low vitamin D, iron deficiency, dehydration.
• Sleep Disorders: Sleep apnea, circadian rhythm disruptions.
• Other Physical Factors: Chronic inflammation, medication side effects, cardiovascular dysfunction, addiction.

Low Energy and Motivation

• Causes: Chronic fatigue syndrome, sleep disturbances, medication side effects, hormonal imbalances, and chronic stress.
• Emotional and Cognitive Factors: Depression, anxiety, schizophrenia, PTSD, and cognitive distortions like hopelessness and helplessness.

Sleep Disturbances

• Contributors: Sleep apnea, hormonal imbalances, hypervigilance (especially in PTSD/CPTSD), addiction, medication side effects.
• Impact on Mental Health: Poor sleep exacerbates issues like low energy, depression, and anxiety.

Attention and Concentration Difficulties

• Physical Causes: Blood sugar issues, dehydration, cardiovascular disease, thyroid imbalances.
• Cognitive and Emotional Factors: ADD/ADHD, anxiety, depression, schizophrenia.

Social Withdrawal and Isolation

• Oxytocin Role: Low levels or ineffective response to oxytocin can lead to social withdrawal.
• Mental Health Connections: Common in schizophrenia, autism, anxiety, and depression.

Anxiety and Worry

• Nutritional Deficiencies: Imbalances in magnesium, vitamin D, and B vitamins.
• Other Causes: Hormonal imbalances, sleep dysfunction, side effects of medications like benzodiazepines and antidepressants.
• Addiction: Stress from hiding addiction or withdrawal symptoms can exacerbate anxiety.

Conclusion

Chapters:

00:00:00 - Introduction to Differential Diagnosis and Framing Bias

00:06:54 - Assessment of Depressive Symptoms

00:14:03 - Causes of Depressed Mood

00:20:58 - Underlying Causes of Fatigue

00:28:00 - Factors contributing to sleep dysfunction and low energy

00:34:58 - Sleep Disruptions and their Causes

00:41:37 - Restlessness: Causes and Solutions

00:48:44 - Factors Contributing to Anxiety and Worry

00:55:29 - Causes of Low Motivation

01:02:15 - Wishing You an Amazing Week

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