[NikkiCC]

Hi everyone,

I was diagnosed Bipolar 1 for the first time three weeks ago by two psychiatrists, and then again diagnosed Bipolar 1 last week by another MD.

So logically I have been striving to accept the diagnosis but there's been a problem that's bothering me.

I see therapists (more than one, in partial hospitalization) and none of them believe the diagnosis, or perhaps they are playing weird head games with me, asking me what I think, one day saying that I fit all the criteria, then the next day saying they think I'm not, and asking me why it even matters.

I'm confused! Have any of you ever had MD's say you are, and therapists say you're not? I'm privy to wanting to believe that I am not, but that seems like a disastrous course to take and I've been trying to be responsible about taking meds and all the other 'lifestyle changes' that I should be.

Thanks!

[Darth Bane]

perhaps you need to fire one of those just choose the diagnosis you like

[Victoria'smom]

My T & pdoc disagree. The funny thing is originally based on intake information my T approved dx. I strive to accept the things they both agree on Med compliance. I choose to accept the paper dx. T & I have talked about my dx probably on 2-3 occasions. If talking about dx bothers you tell T's why. I also have told T that i outright disagree with her dx and why. You could also sign releases for everyone to talk and ask them to all get on the same page. T sees more of my day to day behavior but pdoc has an overview. I often ask T what does pdoc need to know between now and the last time I saw him. It's to easy to forget all the relevant information in between months. Both day to day information and overviews are important but will lead to conflicts.

Yes, and I've learned to listen respectfully and then do what I know is best for my physical and mental well-being. Most important for me is the fact that they know how to medicate gently with the least possible dosage so I can respond to it without too much "drug sensitivity".

Try not to worry about one psychiatrist vs another on the designation of the type
bipolar you are. Just learn that you need medication to stabilize the chemical
imbalance and work on your diet--something that will make it far easier for you to get along well in your life.

[ultramar]

It sounds like it's important to you so if I were you I'd try (again) to talk to them about it, especially if the two different diagnoses are treated very differently (or are the therapists not suggesting a different diagnosis, just saying they don't think you have bipolar?). Maybe you could ask your psychiatrist why he/she thinks you fit the criteria and bring that to the program therapists and discuss it with them. And vice versa, for that matter.

As far as which medications are appropriate and which approaches to therapy might be more appropriate, I personally think it's a good idea for the treatment team to be on the same page -in an ideal world, anyway, may end up not being possible.

There seems to be a prevailing attitude these days amongst some psychiatrists and therapists to say 'diagnosis doesn't matter' --I've heard it from different people on different forums (reporting that they've been told this). But at the end of the day they are diagnosing us... so I feel like there's this cyclical reasoning goes on. In any case, if it doesn't matter to them, but matters to the patient, then for that reason alone, I think they should be open to discussing it.

So you could talk to both of them about the diagnostic criteria of the different diagnoses related to what your experiences have been. Maybe in discussing it in more detail you will be able to decide what diagnosis you feel best describes your experience --if your psychiatrist and therapist continue to disagree then this may be the best you can do with the situation.

This sounds a bit frustrating/confusing, I wish you the best of luck.

[NikkiCC]

Thank you everyone for replying.

Well, diagnosis is pretty important for me as I'm military and now I'm being chaptered out of service after 9 years.

The MD's say Bipolar, and I have responded to the medication cocktail I'm on for BP, but the military is kicking me out for Borderline Personality Disorder because the therapist says I'm BPD and the MD's are wrong.

I feel a deep sense of shame, especially as the therapist is implying that I have lied and created the BP diagnosis out of thin air. It's hard to accept the DX, though I know it is true, especially when I'm told by the therapist that 'there's nothing wrong with you but an inflexible personality'.

I was wondering if this type of confusion tends to be typical for BP DX.

In the end you all are right though, I have responded to med treatment for BP and at least I know that.

Thank you.

[Victoria'smom]

Is there a way you can wipe everything clean and see a neuro-psychiatrist? It is possible to have both BP and BPD. I'm confused why one professional's opinion would be outweigh the others. I think they choose your therapists opinion solely so they could chapter you out. I would request your team to work together. Tell them you need to know your actual Dx. for work.

[newtus]

Originally Posted by Miguel'smom

Is there a way you can wipe everything clean and see a neuro-psychiatrist? It is possible to have both BP and BPD. I'm confused why one professional's opinion would be outweigh the others. I think they choose your therapists opinion solely so they could chapter you out. I would request your team to work together. Tell them you need to know your actual Dx. for work.

im curious....
what woould a neuropsych do in comparison to a regular psychiatrist ?

[newtus]

Originally Posted by ultramar

There seems to be a prevailing attitude these days amongst some psychiatrists and therapists to say 'diagnosis doesn't matter' --I've heard it from different people on different forums (reporting that they've been told this). But at the end of the day they are diagnosing us... so I feel like there's this cyclical reasoning goes on. In any case, if it doesn't matter to them, but matters to the patient, then for that reason alone, I think they should be open to discussing it.

yes.
im one of those people that have been there.
ive been told that by all therapists ive ever had and by two psychiatrists.
i notice its mostly therapists that say that.
which logically..is baffling.
maybe its not... because psychiatry is MEANT to diagnose.
thing is therapy pretty much occurs in the same field...you know? so i dont understand. i understand them not wanting people to have their life run by the label - the word - the paper. but why say diagnosis doesnt matter? i used to believe that and then psychiatrists mostly would say otherwise. not to be dramatic about the whole situation but it has put a complex on me of some sorts. because in an overall sense i KNOW it matters. but at the same time im afraid to talk about it as if its "taboo" while in the therapy room.

[Victoria'smom]

It's a far more in depth testing then psychiatrists do. It tests for biological issues (like hormonal, or nutritional issues) , physical brain abnormalities, visual issues, Educational Issues, and Psychological / personality issues. Usually testing takes several days and have several different tests for each area.

So to me probably have a far more accurate dx. I've never gone through the testing but when we scrap together the money my son will.

[newtus]

Originally Posted by Miguel'smom

It's a far more in depth testing then psychiatrists do. It tests for biological issues (like hormonal, or nutritional issues) , physical brain abnormalities, visual issues, Educational Issues, and Psychological / personality issues. Usually testing takes several days and have several different tests for each area.

So to me probably have a far more accurate dx. I've never gone through the testing but when we scrap together the money my son will.

thats neat.

unfortunately i dont think i have the money for that. otherwise id look into it myself.

i wish the best for you nikki.

what ever the outcome we'll be here for you

if you're not, then i am sure you will be more happier about it- and if you are, well you've got a whole forum of people who have been their.. so i wish you the best.

(((((hugs))))))

[faerie_moon_x]

Originally Posted by newtus

thats neat.

unfortunately i dont think i have the money for that. otherwise id look into it myself.

You should look into if Medicare would cover this, actually.

[rossiv46]

I had the same problem. My Psych had me as major depressive and I started seeing a psychologist who had me as bp 1. I was confused because they both didn't agree and it did bother me. IT's like what am I? I talked to both and later the PSchiatrist changed his dx.

[newtus]

the thing that sort of gets me with professionals in this field is why so many of them have different conclusions or dxs for someone. i understand its common and ive been through it too but for something thats studied heavily in years and practiced daily nowadays - youd think it would mostly be unanimous - the dx. i mean they all use the same manual etc

idk maybe im being too judgemental. but for a field that considers itself a science - the conclusions reached - youd think most everyone would be on board.

[ultramar]

Originally Posted by newtus

yes.
im one of those people that have been there.
ive been told that by all therapists ive ever had and by two psychiatrists.
i notice its mostly therapists that say that.
which logically..is baffling.
maybe its not... because psychiatry is MEANT to diagnose.
thing is therapy pretty much occurs in the same field...you know? so i dont understand. i understand them not wanting people to have their life run by the label - the word - the paper. but why say diagnosis doesnt matter? i used to believe that and then psychiatrists mostly would say otherwise. not to be dramatic about the whole situation but it has put a complex on me of some sorts. because in an overall sense i KNOW it matters. but at the same time im afraid to talk about it as if its "taboo" while in the therapy room.

I have definitely gotten the 'taboo' feeling. We are all on the same page now, but I get the sense that they don't want to talk about it. It seems to be a 'trend' amongst mental health clinicians these days and I just don't get it. I get all of my medical (I have a couple of medical conditions) and psychiatric care in the same hospital (clinics), which means that all of my doctors can see all of my diagnoses. They're sending diagnoses to insurance companies. So it's out there, we are 'labeled' whether we like it or not.

I get the not labeling thing (and there's a part of me very averse to be put in a nice neat box) but not that taboo feeling that you mention and that I have felt too. With my other doctors there's no question as to discussing diagnosis, it's perfectly normal, and drives treatment.

Sorry to get off topic, but why do you think they avoid it (aside from the labeling thing)?

[ultramar]

Originally Posted by newtus

thats neat.

unfortunately i dont think i have the money for that. otherwise id look into it myself.

As I think I've mentioned before I work in healthcare (though not mental health field) and almost exclusively with patients on Medicaid -some of my patients have done this testing so I know that at least Medicaid pays for it. I think you just need a referral justifying it, like for anything else.

[shortandcute]

There's been some slight discrepencies, but they are all pretty similar.
Like my PDOC is sure I have PTSD, but my psychiatrist thinks I might just have some of the traits; she did say she didn't want to totally rule out PTSD. One dr. diagnosed me with generalized anxiety disorder and my current therapist says "Anxiety Disorder, NOS." My psychciatrist says "social phobia" but my therapist thought it may be more like avoidant personality disorder (I'm going with the former, tho, cuz that's my 'paper' dx).
Two things that have been totally agreed upon is clinical depression and personality disorder, NOS.

[ultramar]

Originally Posted by newtus

the thing that sort of gets me with professionals in this field is why so many of them have different conclusions or dxs for someone. i understand its common and ive been through it too but for something thats studied heavily in years and practiced daily nowadays - youd think it would mostly be unanimous - the dx. i mean they all use the same manual etc

idk maybe im being too judgemental. but for a field that considers itself a science - the conclusions reached - youd think most everyone would be on board.

I feel like some of the disagreement may come from severity of symptoms -the threshold of severity that 'qualifies' for a certain diagnosis. Lots of people can experience all kinds of symptoms in the DSM, but the severity of them I think is pretty subjective and not well guided by the DSM. I have a feeling that that's where at least some of the disagreement stems from.

I think with Bipolar some of the confusion (and which can also be pretty subjective) is if symptoms stem from a life event or sort of out of the blue. Of course it's not that simple, because bipolar episodes can actually be triggered by environmental circumstances. So I think this is pretty subjective on the part of the psychiatrist and also on the part of the patient (for example, someone might not remember or recognize while talking to their psychiatrist that x happened just before the onset of symptoms). All pretty subjective.

I think there's also confusion over what a 'normal' (or within 'normal limits') reaction to a life event is and what's 'pathological.' i.e. normal grief from the death of a loved one vs clinical depression, or you're going through a terrible divorce vs major depression, you go on a huge spending spree (for any number of reasons) vs mania, you're promiscuous (for any number of reasons) vs mania, etc., etc.

Sorry this is off topic. To the OP, I wish you the best. I really would try to parse out with both of them as to why they think you fit the criteria for one and not the other and ask if you might fit the criteria for both.

[newtus]

@ultramar

i agree with that. i believe severity is part of it. as well as what is normal. def agree on both.

do you have bipolar disorder?

[NikkiCC]

Wow, thank you everyone for so many replies, input, and encouragement! I'm hard put to answer everyone individually but I appreciate it all.

Today I saw the therapist whose personality disorder DX was putting me out of the service on a chapter. He said at this point with 3 MD's saying I am bipolar 1, he accepts it.

Funny thing I have noticed is, that therapists seem to want to normalize things. He kept saying he doesn't understand why I fell apart into a mess (his words) when I was doing so well. When I told him it was hypomania, not actually 'doing so good', he said it was sneaky to fool him. I explained the delusions I was having, and he said, well, monks do that too. I gave up.

I understand too what another poster said about the elephant in the room. I don't define myself by my DX, but it does have an effect on how I feel about myself, the things I have done, the things I may do.

It is also like dropping a bomb in group therapy too, I feel at least. We can talk about abuse or traumatic events all day long, but don't ever talk about a hallucination or a delusion. Cue the uncomfortable silence.

So, at least the dilemma is calmer about the DX confusion. Even the daft therapist has to accept that I am not a liar to be able to fool three MD's in a row.

It is still to be seen whether he will do the right thing and initiate my med board, which I should have with a DX of BP - not just getting kicked out.

Thanks so much everyone. I am thinking I may start posting here; I feel very isolated as BP in group therapy and individual therapy. It's like you feel penalized for wanting to talk about anything to do with BP - "it's just a label, you are the way you are" is getting old. Thank you!

[insideout]

I had way too many conflicting diagnoses so I ended up "firing" all of the doctors.
firing as in stopped going, and stopped the prescribed treatments.
I am just as confused now as I was then.

I think it is more important what you believe.

[newtus]

Originally Posted by insideout

I had way too many conflicting diagnoses so I ended up "firing" all of the doctors.
firing as in stopped going, and stopped the prescribed treatments.
I am just as confused now as I was then.

I think it is more important what you believe.

how many diagnoses did you end up having? sounds disconcerting

[insideout]

Bipolar 1, Major Depressive Disorder, Chronic Fatigue Syndrome, Insomnia, Post Traumatic Stress Disorder, Bulimia Nervosa,and Panic Disorder.

So many other miscelanneous "disorders" just filling up my chart.

I was taking several medications: Lamictal, Trazadone, Seroquel, Lunesta, Effexor XR, Prozac, Klonopin, ,...

More symptoms meant adding another med.
I discontinued my medications one by one over the last year, and am now off them.

I am not really sure how I feel at the moment, but I do qualify for a Bipolar 1 dx at any given moment.
I also have spells of forgetting things and doing things out of character like someone with multiple personality disorder, but it could all be PTSD.
I just wont do therapy.

[AeonDM]

"I just wont do therapy."

DIY. Better than let it be... I may be wrong.