Abundant Life Psychiatric Service, LLC

08/02/2026

This is where providers like Dr. Fran Kendall, MD at VMP Genetics steps in. She asks for all the data from every health care system and spends several days before your appointment reviewing the entire medical picture. For many people with complex medical issues, this appointment is the first time they have been able to have a clear picture and plan provided to them. VPM Genetics remains our number one recommended geneticist referral because the experience and attention to detail Dr. Kendall provides.

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Most people with complex, multisystem conditions have years of medical data scattered across clinics, specialists, and time. Lab results sit in one portal. Medication reactions were mentioned once and forgotten. Childhood symptoms were never connected to adult presentations. The information exists, but no one has organized it into a single, coherent picture. That gap, between having the evidence and being able to use it, is where most diagnostic delays live.

This gap becomes especially consequential when genetics enters the conversation. Genetic testing has become more accessible, and many people with unresolved multisystem symptoms pursue exome or genome sequencing hoping it will provide the answer their clinicians haven't found. Sometimes it does, but more often, the results come back with variants of uncertain significance, findings that could be meaningful or could be noise, and no clear path forward.

The difference between a variant that gets classified as significant and one that stays uncertain often comes down to phenotype correlation: can the patient's observable biology be matched, precisely and systematically, to the pathways the variant gene affects?

Before asking what your genes mean, make sure you've accurately described what your biology has been doing.

A vague symptom list won't get you there, but a precisely constructed phenotype can change the interpretation of a variant, shift a differential diagnosis, or reveal a pattern that no single specialist had enough information to see.

07/30/2026

The average time to diagnosis for hypermobile Ehlers-Danlos syndrome (hEDS) is 10.39 years. That number describes how long the average hEDS nervous system reorganizes itself before anyone intervenes.

The dismissals, the psychiatric labels, the years of being told it's anxiety or deconditioning: those are the visible face of diagnostic delay. The less visible consequence is biological. A decade without a diagnosis is a decade of unmanaged nociceptive input, with the nervous system altering in response.

When connective tissue is structurally abnormal, joints move in ways they shouldn't, and that movement generates a constant stream of nociceptive (pain-signaling) input to the spinal cord and brain. In the early stages, it's mechanical pain: a joint fires a signal, the brain registers it, and the signal stops when the joint stabilizes. The system is working as intended.

But the nervous system is plastic, meaning it changes in response to the signals it receives, and sustained nociceptive input is one of the most powerful drivers of that change. When pain signals arrive relentlessly for years, the dorsal horn neurons in the spinal cord begin to reorganize. Their activation thresholds drop, their receptive fields expand, and the inhibitory circuits that normally dampen incoming signals start to lose their effectiveness. The result is 𝗰𝗲𝗻𝘁𝗿𝗮𝗹 𝘀𝗲𝗻𝘀𝗶𝘁𝗶𝘇𝗮𝘁𝗶𝗼𝗻, a state in which the central nervous system itself has become the amplifier.

At that point, the pain is no longer a direct readout of what's happening in the joint. Stimuli that would normally be innocuous, like light pressure or normal movement, now register as painful. Stimuli that are genuinely painful feel disproportionately intense and last far longer than they should. The pain has spread beyond the original site, and the system that was supposed to protect the body has become the problem.

That's what a decade of undiagnosed hEDS can build. A 2016 study in the European Journal of Pain found that patients with joint hypermobility syndrome and hEDS showed lowered pain thresholds and an increased wind-up ratio (a measure of how quickly the spinal cord amplifies repeated pain signals), consistent with central sensitization, despite showing no evidence of nerve damage. The pain is a structural change in how the nervous system processes input, driven by years of unrelenting mechanical instability.

That's also why the psychiatric labels accumulate during the delay. Central sensitization produces a clinical picture that looks, on the surface, like anxiety, somatization, or functional neurological disorder. The pain is widespread, the triggers seem disproportionate, and the patient can't point to a single structural lesion that explains it. A survey of 505 individuals with confirmed hEDS found that the average patient received 10.45 alternative diagnoses before the correct one, with anxiety, depression, and fibromyalgia among the most common. Those labels follow a pattern. They're the clinical system's attempt to categorize a centralized pain syndrome it doesn't yet have the framework to explain.

By the time a diagnosis arrives, the clinician isn't just treating the original connective tissue problem. They're treating a nervous system that's been reorganized by a decade of unmanaged input, and that reorganization doesn't reverse itself simply because the underlying cause has finally been named.

That's why earlier pattern recognition matters, and why the question of what to do with a diagnosis is almost always more complex than the diagnosis itself suggests.

07/30/2026

07/30/2026

Is it bipolar or is it something else? Bipolar disorder remains one of the most misdiagnosed psychiatric disorder. Over the past 20 years it has become evident that many people are misdiagnosed bipolar when in fact they have a personality disorder, PTSD, ADHD, or a complex combination of the three. This can become even more complicated when there are underlying medical conditions. Bipolar disorder remains the number one misdiagnosis we see (outside of autonomic disorders being misdiagnosed as anxiety). In fact, studies have shown up to 40% of people with borderline personality disorder carried a misdiagnosis of bipolar disorder for years. The real world consequences are heartbreaking. For many of our clients this misdiagnosis resulted in decades of over medication while the actual problem remained untreated. Bipolar disorder is both over and under diagnosed. Make sure to find a provider with extensive experience treating bipolar disorder, both in a hospital and clinic setting. Speak directly to your provider about how they reached your diagnosis and make sure that your diagnosis is not based entirely on a check list.

Bipolar disorder has become greatly over-diagnosed through the past 20 years. Understanding what has happened to bring about this problem is key to solving it.

07/25/2026

This happens all the time at the office 🤣

ADHD is one of the most highly heritable psychiatric conditions, with studies estimating its heritability rate between 74% and 88%.

07/22/2026