[robw]

I am almost positive that I have bipolar disorder, there is a strong family history of it on my father's side of the family. I have all the symptons, with the exception that I've never had a manic episode (some hypomanic but never full fledge mania). So this leads me to believe that I have bipolar II disorder.

However, my psychiatrist told me that I am not bipolar because my moods are not severe enough and because I am not suicidal. The thing is, I don't even talk to him. My sessions with my psychiatrist usually last 5-10 minutes, just long enough for him to increase/decrease or change my meds. I currently take 1200mg trileptal and 600mg lithium a day, to control my mood cycles.

I have a therapist, who I talk to for an hour each week for various issues I have. She seems to think that it is a strong possibility that I may be bipolar.

My question is should I seek out a second opinion with a new psychiatrist? It just seems a little weird that because I haven't attempted suicide that I can't be bipolar. I have several people in my family that are bipolar and not one of them, to my knowledge, has attempted suicide. It just makes no sense to me.

[ladyjrnlist]

Yes, get a second opinion. That way you will feel comfortable.

[BNLsMOM]

If you feel uncomfortable with your doc, then you might seek out a second opinion.

Just because you have never attempted suicide doesn't mean that you don't have bipolar. However, the meds you are taking are both mood stabilizers, Lithium being the only true mood stabilizer, and Trileptal being an anti-convulsant that has mood stabilizing properties.

Diagnosis is so hard, that even if you went to another psych, you might still walk out without the answers you are seeking, but you should be comfortable with your treatment team. It took me 4 different doctors until I found one I felt good about working with.

[Ryask]

Absolutly, i have never really attempted suicide..well at least never expressed it to a T and i was diagnosed bi-polar...so..get a second opinion.

[robw]

Yah, that's what I'm thinking. I have a suspicion that he does not want to diagnose me bipolar because I am in the military, and he is a military doctor, and if I am diagnosed bipolar then it is an automatic discharge from the military. His goal is to keep people in, not kick them out, so I think that is why he says that I just have "cycling mood patterns" as opposed to bipolar I or II.

[flawlessimperfectionsmft]

I have never committed suicide straight up but I was still diagnosed with bipolar II. I don't know what you psychiatrist is thinking so I think you should get a second opinion.

[blueoctober]

Welcome robw.

If you're concerned that you aren't receiving the correct treatment I would suggest speaking to another pdoc. It's your health and I think it's important to have one's concerns heard. I'm a little confused with the medication you have been prescribed because as BNLSMOM noted they're both mood stabilizers. Have you been diagnosed with something other than BP? I hope you find this site supportive.

[robw]

I have not been diagnosed bipolar at all. My pdoc says that I have cyclothymic disorder, because according to him I'm not suicidal and my moods are not severe enough. Yet, he has not even asked me or talked with me about my moods and wouldn't even know if I were having suicidal thoughts or not.

[sugahorse1]

I don't think you need to have had suicidal urges in order to be dx'd Bipolar. Bipolar however is characterised by drastic mood changes; maybe your pdoc doesn't feel your depression has been severe enough, and with only having had hypomania, you may not meet all requirements as per the DSM.

I'm not sure why the label of bipolar is so important. For me, I just want to tell my pdoc about the symptoms and get meds prescribed to help with these symptoms

[Skully]

I don't think your doctor is worth much...you do NOT have to be suicidal to be bipolar II. Also, you could have had a manic espisode at some point in your life but just don't realize it for what it really was. That happened to me. It took me a while but I finally went through my life and gave examples. But my pdoc knew it already and had begun treatment for bipolar II before I even gave the examples. You can be bipolar II most recenent episode depressive. That was how I was dx'ed. You can always go for a second opinion!

[blueoctober]

Originally Posted by robw

I have not been diagnosed bipolar at all. My pdoc says that I have cyclothymic disorder

Cyclothymia is on the bipolar spectrum. The difference between cyclothymia and a BPII diagnosis is a major depressive episode. Cylothymia does have hypomanic and depressive episode, but not major depression. Either way you're being treated for bipolar and does it really matter if your doctor has diagnosed with BPII or cyclothymia? I thought I was BPII when I was diagnosed and 3 years later I found out I was diagnosed BPI. After I thought about it the label didn't mean anything as long as I was getting treated properly.

[BNLsMOM]

At some point I know label won't matter to me, but since my treatment isn't working yet, it is very important to find out. If I know what I am fighting, I can choose the most effective weapons.

[BlackPup]

I agree with the second opinion idea... but make sure you are totally honest with your pdoc, don't leave anything out. They are not mind readers...

[robw]

The label is not necessarily important in the long run, but like BNL said the meds are not working. I've told my pdoc this, I told him they help some but I still cycle all he does is just increase the dosage. I understand it's a trial and error thing but I have been seeing him every 2-3 weeks for going on 9 months now and it is getting so frustrating I can barely take it anymore.

I didn't start cycling until about a year/year and a half ago, before that I was just depressed for about 3 years.

[Fresia]

Get a second opinion because the meds are not working not b/c you need a different diagnosis, it's just a label. The treatment is what matters. But be sure they know what you've told us about being depressed 3 years ago and started cycling when you did, and that the current meds are not working with your current symptoms.

If a BP diagnosis is an automatic discharge and you suspect the doc is keeping that diagnosis from you to keep you from having to be discharged.... he is treating you in the process with appropriate meds for bp regardless of the diagnosis. Treatment is never a fast process but does need to be adjusted if not working, so you have to go back to him or get a second opinion as it is not working. BUT you also have to decide if BP does become your diagnosis from either the primary treating doc or the second opinion, are you prepared for the discharge? He might be protecting you if you are not ready for that, as too many changes at once sometimes can be more harmful than helpful. So no matter the diagnosis, as long as you are being treated is what is important until you know what important to you...the label or this career, but continue with treatment in the process.

My doc won't actually discuss dx with me as he says the focus becomes about the label, and negatively so, and not focusing on the treatment. Whatever the diagnosis, as long as I am being helped, I don't actually care what they call it.

Hang in there in the meantime as I know it is not an easy time. Sending good wishes your way.

[robw]

Yeah, I understand all of that. It's just that I'm the type of person that has to know, everything. So for me it is more frustrating not knowing the truth than just taking a bunch of pills in hopes that they will help.

As for getting out, I am more than ready for it. My wife and I have been planning for this ever since the thought of a bipolar diagnosis came up. I am a few months away from finishing my degree towards a new career that I am so looking forward to, although it will be stressful at time it is a good stressful.

[Fresia]

Excellent. Then you are prepared. Congrats on the degree and the new career and here's to getting things on track! I do hope things get levelled out soon for you.

[robw]

Thanks, to everyone. I was really bad off earlier tonight, and I am at work (I work shift work and now I'm working nights 12hrs ugh). So I really had no one here to help me through it, but posting on here and reading what others are going through lets me know that I am not alone (even though I feel that way).

[blueoctober]

Were you on any other medication before you started to cycle i.e. had you been prescribed anti-depressants? For many with bipolar finding the right medication is highly frustrating. I do believe in giving a med the chance to work before I voice my concerns (unless it's causing me to go hypomanic). If you have been on the med/dose longer than 3 months it's worth requesting a med change.

I'm also a type A personality and what helped me was to read quality books on bipolar. The one in my signature is excellent and since it's written for spouses, family members your wife may find it helpful.

Have you found shift work triggers your symptoms? It's not ideal for someone with BP to work shift and/or have irregular sleep patterns. After my diagnosis I had to get permission from my pdoc to go back on shift. I do notice a dip in my mood after my nights, but it's been manageable. I really enjoy my job and shift work is part of it, but if you don't really enjoy your career perhaps a job change may help?

[robw]

I do not enjoy my job at all, one of the reasons a BP diagnosis is so important since it will allow me to get out of it. And yes, during my depression I was on several different anti-d's (Celexa at first, then something else cant remember, and finally Zoloft). I was up to just about max dosage on Zoloft, but nothing seemed to be helping then that's when I started seeing the psychiatrist. Prior to seeing the psychiatrist my primary care doc was the one prescribing the anti depressants.

As for the shift work triggering, not really sure. It is a good possibility, but considering the alternatives at this point in time shift work is the lesser of the evils. At least on shift I have plenty of time to do homework.