Some pdocs say I'm bipolar. Some say "no."

Over the years, since about 2002, I have gotten diagnosed and undiagnosed with bipolar disorder a few times. I had problems with depression since childhood, with it derailing my functioning starting at age 19, and then getting really serious at age 24. After starting on amitriptyline at age 25, I functioned a whole lot better.

In 2006, a psychiatrist who had treated me for 6 years suddenly said, "I do think you are bipolar." We had gotten into an unpleasant exchange and we both lost our temper. Next I got a letter from him saying he would not treat me anymore. (Legally, he was able to do that because I had an appointment with another pdoc, for a second opinion.) Then I got told I might have bipolar disorder type II. "Then I was told that it couldn't be more than cyclothymia.

A few years later, I got told by an advance practice nurse who was prescribing for me that I definitely was bipolar. For the past year I am seen by psychiatrists at the main psych facility in my city, and they don't seem to see any evidence of bipola

My own opinion is that I used to get episodes of hypomania, which I loved getting because I would get so much done. For a few years I haven't been getting those "way up" episodes. I used to call them "getting on a roll." People would ask me if I was taking special vitamins because I seemed so energetic. Well, I stopped getting those episodes, and started having just episodes of depression and, occasionally intervals of just feeling okay.

For three weeks now, I have not been depressed. It's like a miracle. Last evening I was compulsively cleaning up the house and enjoying doing that so much. I haven't even gone to sleep this past night at all. I've wanted to just keep on doing stuff. I feel strongly driven, wanting to organize everything and my apartment sure is looking better than it has in two years.

I kind of like the feeling of all this drive to do this and that. When the pdocs ask me if I'me ever had a full-blown manic episode, I say no. Truly, I haven't. I don't start thinking and acting in a way that is over the top. I do get pretty amped up, buy that seems to come from

I am falling asleep here, can't hardly see the screen. It's over 24 hrs since I was asleep. I keep putting going to sleet oddly. I'm just about falling off my chair at this desk. I was under such a drive to keep doing things last night. Mood stabilizer drugs that help bipoal patients didn't work that well on me.

I have to end this letter before I fall off this chair.

I hope you got some rest. Sounds really frustrating to have things go back and forth. You should inform whoever is treating you now about your current state of moods. I've been told it's helpful to keep a daily mood journal to track where you are.

When I was in hospital outpatient group therapy in June, the RPN said that the first sign of problems was not sleeping. Whether bipolar or unipolar, not sleeping is not good. Staying up all night cleaning the house is something I would have done in my 20's. Please tell your pdoc or T what you've been doing and about your sleep patterns. Then they'll know how best to help you.

Thanks for the replies. The journal sounds like a good idea. I forget so much of the details of the preceding month when I see the pdoc. Also I agree that the not sleeping is not good, and this is pretty recent. Even when I go to bed at a decent time, I have been waking up at 4 AM full of energy. How weird. Having these things written down would make my meetings with the pdoc more meaningful. Sometimes I don't think they know what to make of me.

((Rose)) I read an article by a psychiatrist once that called diagnostic categories "cheap suits from the bargain-basement rack" that "fit our patients rather poorly". From what I've read online, it is very difficult to get 2 or 3 psychiatrists to agree on a dx. Some people get a different dx with every clinician they see! I was extraordinarily lucky that the 3 pdocs who evaluated me all agreed that I have bipolar II. However, my therapist disagreed. He admitted that he didn't know what was wrong with me, only that he didn't think I was bipolar or borderline. He did keep mentioning that I had symptoms of panic disorder, which is entertaining because I have never had a panic attack...

So, you are not alone in having been diagnosed, undiagnosed, and rediagnosed. It happens to most people who have seen several clinicians. All that truly matters is that you get the right treatment. You've mentioned several symptoms that could easily be related to hypomania; I would tread very lightly with any pdoc who is 100% against the idea of you having bipolar. As for mood stabilizers not working for you...again, this is a common issue for many people who are bipolar. Many people need a cocktail of 4 or 5 drugs, and it takes them years to find the perfect combination.

Jim Phelps is a psychiatrist who has an excellent website dedicated to issues surrounding bipolar II, with an emphasis on variants that involve hypomanias that are so mild that the sufferers are usually repeatedly misdiagnosed with unipolar major depression. I think you'll find it useful; I know I have. Here's the link: http://www.psycheducation.org/

Good luck to you; wishing you health and stability.

Secretum

Thank you for your advice and for referencing me to the resources above. I've just read a good deal there and have visited secondary links I found on the site you gave. I've googled Harvard's mood disorders information. What I've read has correlated with my experience of mood instability.

As you say, labels are not so important, but appropriate treatment is. ("A rose by any other name would . . . . ")

I totally hear you on the matter of treading lightly with pdocs who are totally against (or for) any particular paradigm. I have learned that it does not, in any way, serve me to alienate anyone involved in my care. Mood stabilizers that are used for bipolar have been tried. I think the pdocs will try just about any medication to see what happens. (The empirical approach to diagnosing.)

The reference you provide helps me better explore what might be going on in my life. Also, it is heartening to get input from someone who has experienced, first hand, the disruption that mood disorder can cause. Congratulations to you on getting effectively diagnosed.

I am not so young. To have been struggling for so long, with no end in sight can be demoralizing in the extreme. I watched my father ride the mood roller coaster, and have resultant problems up to his very last day. He never recognized that he had any kind of a problem; everyone around him did. My very stable mother expressed that something was troubling me and that, in her view, it was the same as what was going on with my father.

The modern taxonomy laid out in the DSM, that purports to be a scientific system of categories, sometimes strikes me as not all that stupendous an improvement over the old Greek system of categorizing folks based on the four "humors." (sanguinary, phlegmatic, melancholic, choleric.) It's good to know that not all psychiatrists see this system as unerring scripture. Thanks again.

I have been diagnosed with unipolar depression, bipolar disorder, schizophrenia, panic disorder by all different pdocs. It wasn't until I met a really good one and he could tell I suffered from Bipolar1 right away by the way I was acting. He was a pdoc who specialized in BP Disorder that I never even knew until I after I saw him.

He started me on BP meds. and things started to get better for me. He put me on Lithium right away and, although it helps me stablize, I had really bad reactions to it. He then put me on Depakote and my moods started to improve.

I left him because I was always stuck in his waiting room for about 2 hours waiting for him to see his patents. I got so sick and tired of waiting for my appt. for 2 hours so I went to another pdoc, and he told me right away that I was really manic when I saw him and I didn't even know it.

I agree with keeping track of your moods via a mood chart, bring it with you to your next appt., and then see what he says then.

It must be so frustrating to have to be diagnosed and then undiagnosed over and over again. It must also be very confusing to you.

I hope you are able to get the right diagnosis, put on the right meds., and be able live your life again.

Thank you, SunAngel. It means so much to me to come to PC and find kind words from someone who understands because you've been through it. I'm not hooked up to any kind of peer support network where I live. I don't happen to come across a lot of people in my personal life who've been in the psych system for years. Sure, everybody has some kind of problems. People don't easily relate to psych issues if that has not been the nature of their problems. There is more understanding and compassion here at this web site than I've ever found anywhere. That you took the time to read my post and offer supportive response helps me to believe that there is some kind of solution, if I just keep trying to get appropriate help.

I look at the range of things you were diagnosed with and they're just all over the map. Yet, you hung in there and are still in treatment. I guess that's what we have to do. I have had one psychologist suggest I might have Asperger's syndrome. One pdoc suggested I had Narcissistic Personality Disorder. She was about to write that down in the chart as a discharge diagnosis. I felt I had to protest. She dropped that idea and seemed to be okay with me picking out whatever diagnosis I wanted, within a certain range. I mean you just can't make this stuff up.

Well, I'm rambling now. Thanks again, SunAngel. Thanks to each of you above. I feel less "at the mercy of " whatever, because I'm not alone in this.

Hi Rose,

I'm turning 45 next month and have been diagnosed manic depressive since I was 21, and been through the litany of shrinks and meds. I know the whole deal with this thing. So last week, I go in to see a neuro-psychiatrist and she tells me (this is after 24 years of every un-Godly medication, tardive dystonia, and diabetes) "Your not Bipolar". God O' Mighty. I felt so good ripping that label off my forehead and throwing away that stigma.

I have Celiacs disease and TLE (temporal lobe epilepsy). Which is quite a deal in itself - but, if I had known 24 years ago and had proper treatment and diet what a nightmare it would have saved me.

Don't believe what they tell you. Follow your own heart and head and keep in mind it is part of the human condition to have highs and lows. As my endocrinologist puts it "we're all crazy".

Best of luck,
Sue

You know what's funny Rose, my mom didn't want to have a "mentally ill" daughter and when I was 14 years old, I was out of control with mood swings and OCD. I asked her if she would take me to a pdoc and she said no. I asked my sister what she said no and she told me that my mom didn't like the stigma of having a daughter with a "mental illness".

When I was at the adult age, I sought out treatment on my own with a therapist. My mom actually called her and said the only problem I have that can be causing my problems were allergies. Come on. My dad was having the same issues so I inherited them from him. My sister told me that my mom had enough to deal with with a "mentally ill" husband that she didn't have time for a "mentally ill" daughter. I was brought up to believe that children were the most important people in your mom's eyes, but she would not listen to me.

So, yeah, to make herself feel better, she just told everybody that my problems were caused by allergies.

She has since passed away and I have forgiven her because she must have had her own issues to deal with, but it is sometimes very hard to forget.

Rose, go with what you are feeling and tell your pdoc everything that is going through your head and in your life. This way, he can give you the correct diagnosis. It took me years to find out my diagnosis and I was happy to get it because it explained so much of what I was feeling.

Go with that little voice in your head. Never go against it. If it's telling you something just isn't right, then it isn't. Make a list of all your feelings and thoughts and keep a mood chart. This will help determine your correct diagnosis.

It is frustrating as hell to be misdiagnosed for years and being put on the wrong meds. You need to find out what is truly going on with you so you can live your life the right way. ((((HUGS))))

Shikantaza, I like your endocrinologist. I think he's nailed it!

SunAngel, Allergies. That takes the cake! Nothing like denial, to escape dealing with reality.

Rose, you're right. The DSM is like the Ancient Greek system of the four humors. And current psychiatric meds are like medieval leeches!

I'm sorry that you have been suffering for so long. You are getting help and you won't give up, so your life will not end like your father's. You'll find stability somehow.

And if the 76 in your name refers to your birth year, you're still relatively young! You'e not even 40...and I don't think people are old until they're twice that.

And SunAngel, I can definitely relate. My mom doesn't want to have a "mentally ill daughter" either. When I was younger, I suffered from OCD symptoms (not so much of a problem now). Even though I washed my hands until they bled (probably at least 30 times/day), neither my mother nor my pediatrician considered getting me mental health help. They just told me to stop, over and over again. And, of course, I couldn't voluntarily control it...

She tries to be supportive of my decision to get help for my bipolar, but it is obviously very hard for her. She was adamantly against me going on Lamictal. Whenever I mention getting more therapy next semester, she squirms. She even occasionally makes comments like "I have days when I feel good and days when I feel bad too, but I didn't think it was a disease. I thought that was normal". Ugh. I hide most of my suffering from her because I don't want to hurt her. So I can't make her understand.

Ultimately, I figure that she would be glad that I am getting treatment if she truly understood bipolar. 1 in 5 people with our condition who are untreated die by suicide. I know that my mom loves me, and would rather see me labeled, medicated, and in therapy than dead. This gives me strength to continue with treatment, even though she disapproves.

This is one of the more caring and constructive strings I have seen on this board. I needed this. Thanks everyone for your comments.

The replies I've gotten on this thread have been very affirming, and I thank you all for your encouragement that I keep seeking the best help I can find. I became severely depressed in early September of 2010 and was diagnosed with Major Depressive Disorder. I believe that was an accurate assessment by the doctor. Since July 21, I have not felt depressed. That is over 3 weeks of feeling quite good. It feels like an amaziing turn around from what I'ld gone through for a year prior.

I have a sneakin' suspicion that I have gone from being depressed to being moderately hypomanic (well, not so moderate, at times.) without spending anytime being just neutral, or euthymic. My apartment is starting to look so much nicer. I am taking care of my hygiene and grooming and going in and out of my apartment like anyone would. Those things represent an alleviation of some very serious symptoms. It is 2:30 AM, and I would like to stay up longer. I can think of a dozen interesting things to do. That would be a mistake, I am thinking. I only had 3 hours sleep last night. I have an early morning appointment tomorrow. So I will get to bed now. My meds are making it hard to keep my eyes open. It's just that I have felt so cheerful, and anything I get involved in interests me and holds me attention so that I don't want to stop.

Secretum, 76 is not my birth year. Yes, it would be ideal to have support from family. I've never gotten much of that either, so I understand.

SunAngel, yes - my parents didn't really believe there was a condition called depression. To them, depression was glorified sulking and merited a kick in the butt. My mother did come around, but I didn't even tell my father that I was taking meds. Let's hope we can find the help to improre and reduce relapses, that are so painful and discouraging.

I'm not doing so good as I had been. This downturn started last evening. For one thing that "glow," that I am suspicious is hypomania, is gone. I do miss it. Life seems so sweet when I have that driven "up" feeling. So I think I am on the bipolar spectrum, but I don't care what the pdocs call it, so long as they seem to grasp that I go through this cyclic thing that involves recurrent severe depression. It hasn't been severe for a while now. (a few weeks, which was miraculous.)

My pdoc did say to me during one appointment, "You really get on a roll." That was in response to me be very interested and animated about discussing a med that had been started recently and me giving him good feedback. When I get into an "upbeat state," my mind becomes intensely interested in things. I guess that's why, when I was young, I did very well at school, some times. I would stay up all night writing term papers that would often get highly praised by my instructors. My performance was uneven, sometimes in the extreme. At one college, I got put into a remedial English course for one semester because a literacy test gave me a failing assessment, concluding that I could not even put a coherent paragraph together.

At DBSA, where I sometimes go to attend support group, they split off into unipolar and bipolar for the support groups. If I go to the unipolar group, I seem to be kind of too talkative to belong there. I monitor myself and try to tone it down. The members attending the unipolar group (and they are nice people) seem so inanimate and repressed that I just about want to shake them. In that group, it's so hard to get a conversation going. I feel like I am too high spirited to belong in that group. I get bored in that group.

Occasionally, I attend the bipolar group. There is a lot of talking and laughing in that group. I feel shy of those folks, like I am too inhibited to fit in there. They all seem to be much more outgoing than I am.

I think it is significant that I seem to be on a wave length that puts me in between the two groups. My growing suspicion is that bipolar is a spectrum disorder and that I am on that spectrum . . . somewhere.