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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5113
Experience:  Dr. Mark is a PhD in psychology in private practice
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I have been diagnosed with a mood disorder (296.90)after TBI

Customer Question

I have been diagnosed with a mood disorder (296.90)after TBI 6 yrs ago and a recent surgery with anestheia (hysterectomy) due to a ping pong ball size fibroid tumor. I am disabled with the TBI and a bit cognizant short. I am told and have read people with PTSD (as I have been diagnosed) have a high likelihood of receiving POCD ( post operative cognitive disorder) after receiving anesthesia. I had a change of personality and also OCD and POCD after anesthesia. I went back to surgeon and was told see a physchiatrist immediately. I did and still do, thus the diagnosis 296,90.
Did not sleep for a week after surgery and went to emergency room to receive a shot to sleep and slept for 15 hrs. Proceeded to be up, till 3 or 4 and sometimes saw sunrise each day after that. I had much energy dispite the inability to sleep. From jan till the end of may I did not receive a full night sleep then was perscribed Olexapine and proceeded to sleep. I continued to see physchiatrist and now will start on Trazadone tonight. I am not clear of the diagnosis and would like an end to this problem brought on from TBI. What does 296.90 (unspecified mood disorder) mean and when can I or can I ever be normal again? I am now 57 and had the motor cycle accident in 2007 at age of 49. I just want some sort of life back. What can I expect? Thank u for your time.
Submitted: 11 months ago.
Category: Mental Health
Expert:  Dr. Mark replied 11 months ago.

Dr. Mark :

Hi! I'll be glad to help you with this issue.

Dr. Mark :

There are some separate parts to what you're asking: one is about the definition for the ICD-9 code that represents your diagnosis.

Dr. Mark :

Another is what can you expect in terms of improvement?

Dr. Mark :

Then there is your frustration at the personality changes and cognitive changes due to the TBI.

Dr. Mark :

And finally, there is the PTSD.

Dr. Mark :

So there's a lot going on! You're facing a lot.

Dr. Mark :

Have you had therapy?

Dr. Mark :

Hi. Do you need more time to reply?

Dr. Mark :

Hi. The system says you're typing, but it's been stating that for a while. Are you typing, or is it frozen?

Customer: If you read I am in therapy with a physchiatrist who has a degree also in treating people with TBI and his diagnosis changes with sessions and I understand that but my diagnosis now confounds me as it is not specific and I know it reads non-specific mood disorder but what specifically do I have. I read a lot and bipolar also fits in that catagorys. I did not sleep for months. Will this go away. I know with TBI an average person of a 100 IQ looses 20 points. I had a 154 iq previous. That would make me still above average but I don't feel that way. Will I ever be problem free again?
Dr. Mark :

I'm sorry: the system didn't send through your previous posting. Could you copy and paste it in again?

Dr. Mark :

I only have your response now saying "If you read I am in therapy..."

Dr. Mark :

Thanks,

Dr. Mark :

I wish I could tell you that you will be trouble free. TBIs can improve with time. Your accident was in 2007, that seems like a long time ago, but in terms of TBIs you may be going through changes for a while, but hopefully improvements.

Dr. Mark :

You had a very high IQ. That means that any decline is going to be difficult for you to integrate.

Dr. Mark :

Because you were used to processing on a very high level, right?

Dr. Mark :

Hi. The system has shown that you've been typing now this whole time, about 15 minutes. Is it frozen again

Dr. Mark :

or are you able to read this?

Customer: Yes, but I actually did not know I had a high iq until I recently drug out a test I took with the state. I had been told I did very well but never looked at it until my daughter told me she had scored a 157 and checked. It did make me feel better as it was much better than being a 100 and loosing 20 points. Would not matter tho it seems the same if you lost 20 points after being high or low you would still feel inadequate. TBI is not only harmfull to your self-esteem it is befriending. Friends seem to dissappear as you are not the same person ( personality change) you once were. They also are scard that you are mentally deficient and don't know how to deal. I would just like to have a normal life. What are the chances as I asked before.
Dr. Mark :

This is very hard. I've worked with a number of people with TBIs. Some have made a lot of improvement. None have gotten to exactly where they were before the TBI. This is almost the same for stroke victims in some ways. But you need to know one thing:

Dr. Mark :

As we age, whether we've had a TBI or not, we go through changes. Some people go through hormonal changes that destabilize them. Some people have cognitive decline because of early onset dementia. Then there are other problems. The upshot?

Dr. Mark :

We all have to learn how to adjust to our differing situations developmentally throughout our lifetimes.

Dr. Mark :

The success with TBI doesn't really get measured by "recovery". It gets measured by adjustments made and compensations made and disciplines learned to manage the TBI symptoms.

Dr. Mark :

Does that resonate with you?

Customer: Yes, actually I haven't thought of that aspect in that way. The glass has always been half full for me. Maybe I need to keep that in mind. Thank you, XXXXX XXXXX what do u suppose 296.90 is for me?
Dr. Mark :

I'm going to be very honest with you because I think that's only fair:

Dr. Mark :

296.90 is, to put it nicely, a provisional diagnosis.

Dr. Mark :

It means that the doctor doesn't have enough information to pinpoint a specific disorder. But he/she needs to make an official diagnosis for some reason,

Dr. Mark :

such as insurance companies, etc.

Dr. Mark :

You mentioned a number of "real" disorders: PTSD, OCD, for example. These all have associated symptoms that would fit the Mood Disorder NOS category.

Dr. Mark :

Then the doctor may be uncertain if Bipolar Disorder (BD) may have formed since the TBI. See the situation here?

Customer: So I have always believed that lake of sleep will do you in and if I had been given sleeping pills I would have survived better. What do you think?
Dr. Mark :

I think that most of the effective medications have side effects and with a TBI are unpredictable. But they of course would have helped. But in truth, with a TBI, because the brain needs to be given lots of time to adjust and resettle,

Dr. Mark :

I believe strongly in behavioral techniques to avoid medications:

Dr. Mark :

mindfulness meditation, for example:

Dr. Mark :

there are CDs and downloads for sleeping on Amazon, for example, that you can use.

Dr. Mark :

And taking at least 1,600 mg of Omega 3 is helpful without unpredictable results but good research evidence for moods.

Dr. Mark :

And there are many supplements that aren't as powerful agents as medications are for the brain. So I want you to be understanding of the doctors for not rushing to give you sleep meds as they were concerned for your brain.

Customer: Well you have been very helpful and I guess I have not actually discussed it in depth with physc. I believe I have some info to discuss now. He charges 145 for 30 min. But insurance pays that. Lol thx and God bless!!!!
Dr. Mark :

You are most welcome.

Dr. Mark :

Okay, I wish you the very best!


 


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Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5113
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and other Mental Health Specialists are ready to help you
Customer: replied 11 months ago.
I do not intend to be cheap but disability sucks especially when used to making much. This is not a habit for me but was great info. Once again I appreciate your info. Thx
Expert:  Dr. Mark replied 11 months ago.
I understand. Please don't feel bad. We are all making our way through life and you are one of the tribe of those who stay good in the face of struggle. That's the best tribe to be part of!


All the very best to you,


Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5113
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and other Mental Health Specialists are ready to help you
Customer: replied 11 months ago.
I am not one of good just try to be, thx for compliment. You see deep, how?
Customer: replied 11 months ago.
Dr. Mark , How do u see so deep, you r wright I am a good person. How do u get that from texts? There are many that would and are good at deceiving.
Expert:  Dr. Mark replied 11 months ago.
I'm not sure what you mean: "How do u get that from texts? There are many that would and are good at deceiving."


However, if you mean how do I know that you are a good person it's because you asked questions and were willing to see a new perspective. You weren't looking to just complain and to find fault. That is a genuineness and I appreciate it.


All the very best,


Dr. Mark
Customer: replied 11 months ago.
Wow, if u need a reference I will give it. It is not common for a person to be so observant through text. I also see a very genuine and considerate person. Thx, that to me is a very good person. Nice to know you and good night. : )
Expert:  Dr. Mark replied 11 months ago.
Good night to you as well. And thank you for the kind words,


Dr. Mark

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What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
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  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
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