That second diagnosis sounds...really weird to me.

The symptoms can overlap, sure, but this just seems weird. Watch out for the Lexapro, please, very carefully. This is an SSRI. A HUGE no for bipolars. The SSRIs are especially evil in bipolar people. If she is indeed bipolar this could swing her into full mania, a psychotic mixed state, mania with psychosis,and eventually depression and anxiety and panic the likes of which there are no words to describe. At least with abilify it is "designed" for bipolar depression, but still--an anti-dep and no mood stabilizer?? Very odd choice. Just be careful. Obviously I'm not a doctor...I'm just another bipolar. With GAD and OCD. My premenstrual time (is this the MDD you spoke of? Menstrual instead of premenstrual? Maybe just different wording?) is usually a time when episodes often will occur but I do not have premenstrual dysphoric disorder.

Maybe another opinion is in order. I know. Three. Frustrating. But I think the first one got it right (but didn't do the right thing with the meds) and the second one is a mess. in my VERY VERY untrained professional opinion. Also, here's a secret--some pdocs are dumb. DUMB DUMB DUMB. They mess up meds all damn day and we pay for it while we wait out the side effects, consequences, and various et cetera.

Also, for bipolar, Abilify is not a treatment of its own usually. It's an adjunct treatment (usually) added to mood stabilizers. If there have been issues after the abilify that caused you to seek a second opinion, it may just be that the med was wrong and/or not prescribed fully and correctly. In that case, the diagnosis may have been right and the med WAY wrong.

Find a pdoc you are comfortable with and work with that person. Jumping from one to another to another every time a diagnosis or med feels wrong is counterproductive. A second opinion is never a bad idea, and a third opinion could be valid, but seems a bit much (unless you are just trying to find a doc you like and trust). Find a doc you are happy with and can trust and let the process start and stick with it. And it IS a process. It WILL take time. Maybe a lot of it. And never expect full recovery. Expect less episodes and less severity of episodes. This is a sign of proper treatment. Not being "cured."

If she's had mania and obvious rapid cycling between that and depression, the second pdoc must be wearing blinders or something. In no other disorder than bipolar does that cycle exist. It can overlap with some, but it is what it is.

Just my $.02.