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Old Jan 24, 2020, 07:59 AM
Anonymous35014
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Christina gave excellent advice. I want to add:

Bipolar is a spectrum disorder IMO. That is, not everyone fits perfectly into one category (BP I or BP II). In fact, I made a thread a long time ago asking people if they "fit" their BP diagnosis perfectly. Most people said they don't 100% fit with their diagnosis because they were sorta "in between" BP I and BP II, despite being given a diagnosis of BP I or BP II. So when I think of BP I and BP II, I think it means that the person most closely fits with that diagnosis, but that it's not all cut and dry like doctors want you to think. Thus, when I think of "unspecified bipolar" (AKA bipolar NOS), I think that the person's pdoc is considering the entire spectrum and doesn't want to label the patient with something they don't fit 100%. Is that right or wrong? Not really. It just means either the doctor doesn't know 100% which "flavor" of BP you're closest to, or they think you're in between Dx's and don't wanna give the wrong impression. But nonetheless, it is bipolar and it is serious.

Now personally, I don't think I am BP I. I was diagnosed with "bipolar 1 disorder w/ mood-incongruent psychotic features." Basically, I am said to have bipolar 1 where I experience psychosis both inside and outside of mood episodes. I do acknowledge the psychosis, but I really don't have genuine mania. Hypomania, maybe, but mania? I don't think so. However, there is no such "bipolar 2 w/ psychotic features" diagnosis in the DSM or ICD, so I'm just labeled with "bipolar 1." Thus, as you can see, it's just a label.

At the end of the day, though, your goal should be to get the treatment you need and deserve. I agree with Christina that therapy is a great place to start. If a medication helps you in some way, then maybe you need it or need a medication in that same class of drugs. I do think correct labels are important, though -- not for treatment per se, but for insurance purposes. Prior to my diagnosis changing from "bipolar 1" to "bipolar 1 w/ mood-incongruent psychotic features," my insurance rejected specific antipsychotics because they said those ones were "primarily for treating psychosis" and I didn't have a label that said I had psychosis. Your insurance company might not be that a.nal, though. However, you still want the correct Dx in case your insurance changes its policies or you change insurance companies. (I have Harvard Pilgrim, which is a non-profit Massachusetts insurance company, but they contract out behavioral health services through United Healthcare, and United Healthcare is the one who was rejecting meds. And unfortunately, United Healthcare exists across the country, so there's that.)
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