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I was actually interested in Supanova's post as well and was thinking of starting a new thread about it!
First, the below is all about 'labels' --so I'm not saying whether it's a good or bad thing to have them, just exploring what they mean in this context of multiplicity. Many people put their lists of diagnoses in their signature and/or in the 'about me' thing (as I do), and I think labels can affect/influence our identities.
I agree, Miguel'smom, that some things just fall well outside the realm of BP (and occur outside of episodes) that make sense to diagnose, so this is certainly one reason why someone would have more than one (or multiple diagnoses).
But I wonder if, in some cases (and I'm not really talking specifically about BP here, just in general) there aren't other reasons at play. For example, if someone changes pdocs (once, twice, or more, over the course of a lifetime) then those pdocs may disagree with each other --if current pdoc offers different diagnoses, then does this mean that they are added *on top of* previous ones or *replace* previous ones? I think if the conversation of whether current pdoc agrees with previous diagnoses or not, can potentially lead to multiple ones i.e., current doc believes you have x, previous pdoc believed you had y and z, so do you now have x, y, and z, or do you only have the current diagnosis of x? I think if you go through different pdocs, and they diagnose different things, the question becomes: are these guys disagreeing or are they actually adding on?
If previous pdoc said you had OCD, but current pdoc says you have an 'anxiety disorder' --is the patient supposed to believe they now have both? Or, since OCD is an anxiety disorder (I think?) does current pdoc disagree with previous -doesn't fit OCD criteria, but suffers from anxiety?
Maybe one pdoc diagnoses PTSD, another 'Anxiety' --so do you consider yourself to have both? But PTSD is a kind of anxiety disorder, maybe it's just that current pdoc doesn't think your anxiety stems from PTSD, or doesn't think you fit the criteria, etc.
One pdoc diagnoses 'major depression' and a different one BP are your diagnoses now major depression *and* bp (but isn't depression part of BP, so don't they overlap?). Or if one pdoc diagnosis BPD and another BP, do you now have both or do the pdocs disagree?
If therapist and pdoc disagree (or offer different diagnoses) does that mean you have both or do you have to decide, as a patient, which you agree with (pdoc or therapist) and choose one?
Anyone have any experiences of asking current pdoc if they agree with old pdoc's diagnoses? Has anyone experienced having to decide if everything new is a kind of 'add-on' or if some replace others?
I'm not saying, at all, that multiple diagnoses are inaccurate, just that it's complicated and there can be many roads to this.
So what are your guys thoughts? Can some diagnoses actually be part of just one (i.e. depression and bipolar, etc.) and it would make more sense to diagnose what encompasses others instead of adding and adding? What about the issue of different pdocs (and therapists) diagnosing different things, thus adding to the list, even if they disagree with each other (pdocs disagreeing with other pdocs, therapists disagreeing with pdocs, etc.)?
What a mess, right? But this is the system we have to deal with!
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