How do you get diagnosed?

I have an important appt. tomorrow and I'm so confused. I'm on Cymbalta and abilify. I don't think I should be and will insist somehow to stop both meds. I'm depressed most of the time and I can't sleep and have high anxiety most of the time. Several people say I have bipolar. How do you get officially diagnosed? I can be very persuasive when I believe something and I'm not sure I am bipolar or not so I may talk her out of saying I'm bipolar. I want to do what's best but don't know.. The meds are different than for depression right? Seem really important we get it right because I've been in trouble a couple of times this past week.

How did you get to receive the prescriptions for Cymbalta and for Abilify without having any dx? Abilify is approved for schizophrenia, bipolar, and as an add-on for depression. You cannot get it over the counter. What is your current dx and who gave it to you?

I'd work with your doctor and come to what's right for you...You will know when it's right..Good Luck

I was misdiagnosed by a T so I went to a pdoc for a correct diagnosis. Good luck.

I just changed prescriber's and I can't sleep so last week we addressed the sleep issue (ambien-doesn't work for me) and tomorrow we will get to the rest of it. The last person I saw didn't want me on abilify anymore but when I'm not on it (only 2mg) I'm even more depressed. Cymbalta maybe helps but not enough alone.

So much of prescribing is subjective it seems. I can answer questions differently every time so I'm afraid I won't answer the questions right and I'm not going to get on the right meds. Huge fear of meds that might make me gain weight. I work out and was a pro athlete and it causes more depression when I gain weight. Ugh, feels hopeless and pointless.

Only trying the meds will show what their side effects, if any, are IN YOU. Answering questions is important, but only up to a certain point. Also, tell the prescriber that weight gain is an absolute no-no and decide on a strategy on how you will monitor your weight and rule out offending medications quickly, or, balance the weight increasing tendency of some drugs with the weight decreasing tendency of others (Topomax, Wellbutrin for the most part) to stay in the right zone for you.

If you can afford it, go to a neuropsychologist for a complete evaluation. The tests the neuropsychologist will use work well with the way you answer questions.

I was Dx'd from GP- BP II
pdoc 1- BP I
pdoc 2 - BP I w/ psychosis

As far as weight neutral or weight loss drugs they are out there and you need to tell your pdoc you'd like to try those first.

Don't worry about answering right or wrong answer as completely and honestly as you can.

Scared. I just met this person last week. I trust her because she was highly recommended by my therapist who spoke with her before I went. Still, "trying out meds" just makes me ill to think about because nothing seems to work. They are focusing on sleep because 2 or 3 hours I get each night is starting to have effects now. Can't drive without seriously falling asleep. But I also want to feel better. I understand not being able to do too many things at once with medications so that frustrates me too.

People get diagnosed by doctors. For many people either primary care doctors or a stay in a psych hospital is the first step toward a diagnosis of mental illness. Then they see a Pdoc or T who does an assessment, it used to be that assessments were done with the use of tests. Now it is usually an hour or a set number of hours with talking to the Pdoc or T who has had training in assessments specifically in mental illness. Insurance requires that you have a diagnosis to get treatment that will be paid for by them. If you are paying for it you do not need to be diagnosed quickly and can ask to take more time w/ the pdoc or T before they give you an official diagnosis.

The diagnoses you have will determine how much and what kind of treatment you get. Because mental health is not an exact science sometimes there will be a difference of opinion in diagnoses. There is a manual that doctors use for guidelines for the symptoms.

Medications are very individual and what works for one person may or may not work for someone else even if you are related. So there is a lot of experimentation. The most important part is communicating with your doctor, being honest and taking care of yourself no matter what your diagnoses is; eating right, getting sleep, and exercise. Educating yourself about your diagnosis is important and helps you work with your doctor to get the best medication with the least amount of side effects so you can do what you want in life.

You said several people have said you have bipolar but not if they were doctors. There are a lot of functioning people in the world with bipolar it is not a terrible illness and it is not the end of the world if that is what you have. You can have a full quality life. Just be honest with who ever you have the appointment with so that they can give you the best care they can.

Thanks Sidestepper. That helps. My appt. today is with an APRN. I don't think my Dr. would be best. My therapist could work with the APRN because they know each other and she cares. So, I'm scared of experimentation. I only started all this stuff 3 years ago but I don't have any more patience. I know I need to though. I want to understand this, feel better about what I'm doing and taking. With sleep being the #1 priority I'm afraid we may lose track of time to address the other areas. Hard to know what is going on with little to no sleep.
Thanks again, you helped a lot. Will come back here later to give update on appt. I wanted to add........... if anyone cares

Well, sleep is one of THE most important issues with bp. Hope you get relief soon. I use a low dose of Amitriptyline for sleep - it is an old AD which works very well and is very worth trying, but you have to ask the doctor for it because they usually go for more modern meds first. I highly recommend it.

So for me I went in for my physical at my GP. I was sitting there on the exam table and he walks in and says, "good morning, how are you?" I was then on the floor in a ball weeping. So, he had me take the depression and bipolar tests there in the office, when they came up positive he sent my to a psych who then confirmed diagnosis of bipolar NOS and also gave me these huge tests which got me my other diagnosises. We did some digging and I told her the story about my "possible psychotic episode" which lasted five years. She then gave me the psychotic features thingy, but said she couldn't diagnose schizoaffective off of it because it had ended 5 years ago.

And then my money ran out. I was like $400 in the hole and couldn't see her any more. So I never got bipolar I or II specifically.

That was in 2009. I haven't had any help since then.

Hamster-bamster is right sleep is very important especially if it turns out you do have a bipolar disorder because the lack of sleep can trigger a manic or hypo-manic episode. APRN's are becoming more common now I forgot about that. With more Pdoc's and T's accepting fewer insurances or becoming cash only to avoid all the paper work it's harder to find Pdoc's and T's. I should remember this since this is what I have now too. I haven't had a Pdoc for 3 or 4 years, there aren't any on my insurance.

Please do update how it is going Little Me, I'm interested.

(dark_heart_x) isn't there any public health care where you live that could help? I know where I live is pretty awful(in the USA I'm living in the state that is 50 out of 50--dead last in mental health care!), but they do have a priority list for both bipolar, and schizophrenia, and also major depression but only if you are actively suicidal.

No, only if I was poorer. I have insurance, I'm just too poor to use it. Every specialist visit is $80. I don't have that kind of money. Because I have insurance, the public system won't help me. I've been dealing with this for a long time. I also am in the US. Hurray for crappy insurance!

I was diagnosed when I saw a pdoc. We talked, I told him about my symptoms, told him that my friends and T had noticed and commented on my mood swings and irritability, and he said it sounded like a classic case of BP 2.

From the reading I've been doing here I bet I do have bpII but..... I'm scared. I know it doesn't change anything but mostly 'they' don't want me to feel so great and to control the manic I bet I would be put on something that makes me depressed. I seem to only be in the depressed to ok place for the past year. I don't know what's wrong with me feeling better than ok? I think they are worried about me being reckless and impulsive...... I can be but I am also careful at the same time! I am a person that naturally, before I opened my big fat mouth about my trauma was able to manage and I usually have been known to be a high energy happy person. Now? I have to fake it so much and it is exhausting. I hide my moods because I've gotten so good at it and I can't let anyone see me. My therapist has seen me hopeless but that's it. I have 2 awesome therapists and great insurance too. So thankful and I'm sorry when I read about others that don't. It's not fair.
Thanks, I'm scared, mostly because I will fall into a pit if I gain weight.

If you are mostly in the depressive end, then the meds should be more focused on that. From my experience that is usually how bipolar is handled, they will still want something in place for the hypomania, or mania, which ever one you exhibit.

I have bipolar 1, and when I was on meds, my meds focused mostly on mania and psychosis. I do get depression, but over the years I have learned really good coping skills, and I can pull myself through the depression, with out the use of meds for that.

I hope that helps make some sense out of that. If the meds make you even more depressed, then there is really something wrong with the meds. And that would need to be changed.

Be clear about the weight gain, that tends to make people more depressed, and health wise is not always so good either. Also you should research the medications yourself before you take what has been prescribed. That's true for MI and physical illness. Doctors do not always explain the meds, and side effects well, or drug interactions etc. So best to make sure you know what exactly you are taking. that will also help you make more informed choices about meds, the meds you take is your choice, you have a say in this.

It makes me feel very bad I have good insurance. I pay a lot for it too. I'm sorry, you deserve to get help too.

Thanks. I have bad insurance that I pay a lot for. It's like... what is it for? Insurance is a big joke sometimes.

Don't worry, even if you have bpII, you're still you.

That is so wrong. Under what's wrong with America's insurance plans; they wait until a crisis pt before you can get treatment. Affordability of preventive services is ridiculous. A Pdoc should not be charged as a specialist. A Pdoc is the like the GP for MI, it's not like you can go to a GP or primary care doc for MI med's. None of the PC doc's I've had wants anything to do with MI medications, they always say they don't know enough and refer me out. Under Obama, mental health care is now suposed to be covered the same as any physical illness. However I believe most of his plan is not mandatory until next year, so if Romney is elected it might not happen.

Take care, I hope things change so you can afford to see someone. Kudos for taking good care of yourself in the absence of medical treatment.

Yeah, I keep hoping that something changes for me. Maybe it will. Maybe it won't. Either way I don't give up. I have too much to keep healthy for, even if I do it by myself. I've always had to do it by myself, so that's just how it is.

Hi Little Me, and welcome!

I went to a pdoc for about 4 years, being treated for depression and add. I felt like it came out of nowhere when she dx'd me with bpII. She said that it usually takes many years to dx someone with bp, that I had persistant low-grade depression that was unresponsive to anti depressants. We tried different meds like lamictal and abilify, and I finally went with lithium, she said it would be effective against the depression and stabilize mood. And the lithium has helped very much with the depression. I still have swings, I have hypo/mania, but I feel more stable. It's not perfect but more stable is good for me. I needed the craziness of depression and hypo to slow down a bit so I could get my life together.

Hope your doctor visit went well! Keep us posted.

Thanks, it feels good to see yours and other posts here. Figured no one would notice 'Little Me'. She wavered on upping the Cymbalta and then at the last minute decided to go with Lithium and change to Lunesta for sleep. So, Cymbalta and Lithium and Lunesta that's my plan.

She was really good about making me feel good and telling me how I'm doing important work in speaking out publicly against my abuser and not letting up. We spent half the time talking about how I need to protect and take care of myself. I don't do that well. I get emails daily about the 'situation' and 'his name' is in the subject line each time. I don't think it bothers me but I just got to wonder why do I have to keep visiting this every darn day. It's a great big test I think.

Lunesta is so expensive. They would only give me 2 weeks worth and also don't even know if it works. I think my therapist has mentioned she thought I needed a mood stabilizer. Lithium scares me. It says weight gain possible and I was told that shouldn't happen.
Thanks BlueInanna