Will the Real Diagnosis Please Stand Up?

I was diagnosed by my p-doc 13 years ago with "Major Depression - Recurrent." It took a good year to find the correct anti-depressant in the right dosage to keep my depressive episodes at bay. Finally, p-doc said my depression was "rapid cycling" and he was going to add Depakote to the Zoloft I was taking because Depakote will stop the cycling. Ok, made sense.

Then in a former job, I went out on FMLA and when I saw the info p-doc had submitted, I checked the code in my DSM handbook and found that it was bipolar! I had a friend who was getting her license in Mental Health Counseling and I told her about this and she said "Get that expunged from your record! That is not your diagnosis and you don't want that on your record!" That concerned me so I contacted my p-doc and he said he had put the wrong code down and changed it to Major Depression - Recurrent.

I was also in grad school for mental health counseling at the time and when I prepared my paperwork to submit to the state to be approved for a "license to pursue a license" I needed documention from my p-doc that I was stable. The letter he wrote did not use any codes, but just again stated I had been under his care for the depression.
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Fast forward to the present. I'm currently out on short term disability from work. Once again, when I saw the paperwork p-doc submitted it had the bipolar dx on it again. This time I was too ill to call and question this.

I began therapy again this week (really, really like my new T by the way) and during our session, plus looking at the symptoms I had noted on her paperwork, she said "You don't have depression, you are bipolar." I told her all of the above and she said she had just taken intense training on this. I said I have never had a manic episode - I'm either way down or steady, no highs.

T explained that I am Bipolar II and I'm hypomanic not manic depressive. I asked her to explain the difference but I was so anxious being there to begin with that I didn't really wrap my mind around it then. I was mainly disgruntled with why my p-doc told me one thing, then used a different dx code, then changed it when challenged, then used it again.

I just checked my DSM and I DO see now what T was talking about. The symptoms of Bipolar II are exactly what I experience.

So, hi everyone - will be reading/posting on this board.

Also, anyone else have any experience with their p-doc like that?

My P-doc on first seeing me said I have major depression, apathetic, but I could have bipolar. I said the same thing - But I've never had a manic episode. I'm either low or "normal." He said you don't have to have had a manic episode to be bipolar. I'm pretty confused on that one myself.

Time will tell. I see him again Tuesday after 3 weeks on Wellbutrin.

Yeah, but Wi_fi... remember that as a team, we are bipolar. You're depressed, and I'm manic...

>> I'm pretty confused on that one myself.

We associate Bipolar with depressive episodes and manic episodes... but the diagnosis really applies to mood swings. For many that means swings between really high (manic) and really low (depressive) but it could also mean swings between depression and a non-depressed state, without any manic symptoms. This is what Bipolar II diagnosis is for.

I have periods of depression and periods when I feel better, as I work to get things back under control (medicine and therapy) but I don't really "swing" between the two states, that is why my dx is depression rather than Bipolar.

I'm not sure, but I would assume that someone with Bipolar II could experience the same type of variations as other bipolar diagnosees (is that a word? ) i.e. rapid cycling etc. but it would be rapid cycling with depression/no depression rather than cycling depression/manic.

OK, Dexter, that makes sense now.

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I'm not sure, but I would assume that someone with Bipolar II could experience the same type of variations as other bipolar diagnosees (is that a word? ) i.e. rapid cycling etc. but it would be rapid cycling with depression/no depression rather than cycling depression/manic.

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Great info, Dexter! I am seeing why my dx would tend toward Bipolar II (even if not depressed I often experience times of agitation, insomnia, and some other related symptoms) plus the rapid cycling thing.

Gah, I hate the rapid cycling - I would just like to get some ~peace~ for a period of time!!

Hey Wi - how's the Wellbutrin going? I recall you began yours about a week before me. Side effects calmed down?

They're calming down, but I'm still getting the head bobbles. I gave 300 mg another shot and by day 3 (yesterday) they started in again by late afternoon. Not as bad as the first time though. Whew! I did notice I'm clenching my jaw now.

I'm liking the activating properties on one hand, because it lets me stay up later and get more things done, but it also causes wicked insomnia (now that the 2 weeks of Ambien are done). I took two Benadryl last night and went to bed later, thinking it would let me sleep until closer to wake-up time. Nope. I have to get the OTC sleep stuff that has whatever's in Unisom, not the diphenhydramine variety.

it took them ages to get mine right too. when i was about 15/16 the gp gave me antidepressants that sent me sky high manic, and made me realy violent and she said "it may be manic depression but she's only a teenager so it's more likely to be teenage angst" - no further action was taken. at 23 i was properly diagnosed and it was a relief, in a way, because i'd been having depression treatment for almost 10 years that was just making me iller. i just realy think that doc has a lot to answer for - surely if there's any chance of it being bipolar, you get it looked at and don't just dismiss it as "teenage angst"? angst as a teen is about boys and spots, not about trying to kill people :S

i hope now you have a more clear dx, that the meds and the support make a positive difference for you x

Thanks, Dogtanian!

ACK!! You sure went through an awful time with that "teenage angst" dx. So sorry anyone has to endure that!!! Even though we may not have the medical background, I think we generally know our own bodies the best and know, like you did, that what you were experiencing was more serious than what the Dr. said.

Yes, I expect to have good support now that I have this new therapit. She really seems to be on the right track!

Why would having a diagnosis on your medical record be a problem? There are privacy and confidentiality laws.

if its the wrong diagnosis you get the wrong treatment plan and confidentiality laws are there so that no one OUTSIDE your treatment team knows your diagnosis unless you give permission for them to know or tell them yourself. A professional (primary physician, psychiatrist, psychologist, therapist...) needs access to your past record so that they know what works for you, allergies and so on. Sometimes in the diagnosing process the person recieves many different diagnoses based on professiona knowleg=dge at the time, and how and what symptoms the client hides and discloses. This causes treatment problems and undue stress on the client who is trying to obtain the correct treatment plans. So I prefer the profession see me first as a person and then deal with the diagnosis after. So I tend to HATE diagnosis labels.

Now there wouldn't be a problem due to the HIPAA laws. This was at least 15 years ago and I've only been hearing about HIPAA it seems for the past 5 years or so.

But beyond that, the person who told me to get the diagnosis changed had a degree in counseling and was actively working on her license, so not having much knowledge at that time myself, I figured she "knew."