I understand your frustration, Nola. Sometimes it comforts us to know exactly what's going on, so I get where you're coming from.

I personally think that doctors are reluctant to diagnose BP 1 right away because they aren't sure about the "severity" of a person's upswing symptoms during the initial stages of diagnosis. I think they need to give themselves more time to analyze the "up" symptoms before they hand out the label of BP 1. But that's just my uneducated guess.

If you want, you could always have your therapist share her notes with your pdoc if you want your pdoc to change the label. And despite what people say about the label "not mattering," that's not always true. My insurance kept rejecting my rexulti until it was proven that I had BP 1 with psychotic features. When I just had a plain BP 1 label, they were all like, "nope, you don't need it. This is primarily meant for psychosis. Find something else." Then when my psychosis was mentioned and the label changed, "oh, wow. Looks like you really do need it!!"