[ultramar]

Hi Everyone,

For those of you with lots of different diagnoses (say, three or more), how did you get them? Is it a matter of one psychiatrist rattling off one day that you have a, b, c, and d or is it an accumulation of diagnoses from different doctors at different times?

Check!
I have had a few different diagnoses, but right now I have three I think. That is not to say I don't qualify for others. No accumulation or just rattling off one day. It is possible to have multiple, sound diagnoses.

[ultramar]

Originally Posted by Mandrec

Check!
I have had a few different diagnoses, but right now I have three I think. That is not to say I don't qualify for others. No accumulation or just rattling off one day. It is possible to have multiple, sound diagnoses.

I don't doubt it's possible/valid at all, I was just wondering how it happens. I just can't imagine (which doesn't mean it doesn't happen) a psychiatrist doing an evaluation and then coming up with all of this at once (maybe if it's one of those super-long official neuropsych evals it would be different). So I was wondering if doctors add on additional diagnoses over time or if different doctors have diagnosed different things, thus adding to previous ones, if the doctor diagnosed everything at once, etc. I'm sure it's different for everyone, but just wondering how it came about.

[Odee]

I was originally diagnosed with Depression and GAD. I have mostly seen one psychiatrist who changed this diagnosis to Bipolar 2. I will soon be switching to another psychiatrist. I can see how visiting different professionals could give you all sorts of diagnosis. I'm honestly a little scared that, when I see the new psychiatrist, tat I will be diagnosed differently and taken on a whole different treatment course!

I think with mental illness being more like a spectrum, and the fact that bipolar involves a lot of overlapping symptoms of much of them, I feel as though all of my symptoms can be categorized under Bipolar 2. I have anxiety, panic attacks, very ADHD-like symptoms but I chalk it up to the #2, because they probably all share the same source.

I'm not saying that is a definite for everyone. It's just part of how difficult it is to say where one condition ends and another begins.

[Victoria'smom]

Where I go if the primary dx doesn't explain other issues a new dx is given technically up to six. Depending if you ask my T or my P doc I have 2-4 dx., my son has 3 dx. and husband has 2 dx.

[C.Oliver]

I have Bipolar II, PTSD, OCD, Panic Disorder, Agoraphobia, Anorexia.

They are all so different that they were pretty easy for one Dr. to come up with. It wasn't all at one time, but over the course of several months of getting to know me, along with my therapist communicating with her.

C and Oliver (my Service Dog)

[emgreen]

Originally Posted by Odee

I think with mental illness being more like a spectrum, and the fact that bipolar involves a lot of overlapping symptoms of much of them, I feel as though all of my symptoms can be categorized under Bipolar 2. I have anxiety, panic attacks, very ADHD-like symptoms but I chalk it up to the #2, because they probably all share the same source.

I'm not saying that is a definite for everyone. It's just part of how difficult it is to say where one condition ends and another begins.

I'm BP I, but I agree with Odee about other issues falling under the umbrella of my bipolar. I have anxiety attacks, periodic agoraphobia-type symptoms & generalized anxiety, but attribute all of them to my bipolar. My pdoc never talks about my diagnoses with me...I know I'm BP I, for obvious diagnostic reasons (depression, mania, hypomania, etc.); rather, she deals directly with the symptoms I'm having at any given time. I'll catch hell for this one, but it seems some folks collect multiple diagnoses for all the wrong reasons. I'm no fan of amassing multiple labels when, as Odee posits, "I think (of) mental illness being more like a spectrum, and...bipolar involves a lot of overlapping symptoms."

[cool09]

I think with mental illness being more like a spectrum,

It is. BP's in the spectrum with schizophrenia (and there is a Spectrum within BP called Bipolar Spectrum; http://en.wikipedia.org/wiki/Bipolar_spectrum). Several of BP/schizophrenia symptoms overlap (severe agitation, psychosis and others).

I don't doubt it's possible/valid at all, I was just wondering how it happens. I just can't imagine (which doesn't mean it doesn't happen) a psychiatrist doing an evaluation and then coming up with all of this at once (maybe if it's one of those super-long official neuropsych evals it would be different).

It's very easy. Lots of mental disorders have the same or similar symptoms. I've had every diagnosis since 1986 from schizoaffective to depression to OCD to BP (and most of these were coming from one of the most prestigious Psych Hospitals on East Coast since 1850). Not a great deal is known about mood disorders still. Studies show that a correct diagnosis of BP takes 8 yrs on average. And studies show that 40% of BP patients also have an anxiety disorder (OCD, generalized, etc.) so it's very difficult to diagnose. A diagnosis is not cut and dry especially if you have BP symptoms which run the gamut.

My experience is if someone has severe psychiatric symptoms they do not have good insight into it or any insight at all. That was the case for me. I didn't fully understand what I was feeling for half of my life. I just knew that something definitely wasn't right and didn't know how to correct it. (I just lived with it and it became who I am and controlled me.)

Every hospitalization (x7) I had in early 90's PDOCs would just scratch their heads and was given all sorts of meds including one complete Summer of ECT (x16).

[Atypical_Disaster]

For me it's been an accumulation over the years. Never has a psychiatrist ever "rattled off" any diagnosis to me. Actually, getting them to even tell me directly what my diagnosis is/are is usually a pain in the butt. I don't know if it's just in my head but my pdocs have never liked telling me what they think is going on with me diagnostically speaking. If I ask they look almost physically uncomfortable with telling me!

[BipolaRNurse]

Originally Posted by Atypical_Disaster

For me it's been an accumulation over the years. Never has a psychiatrist ever "rattled off" any diagnosis to me. Actually, getting them to even tell me directly what my diagnosis is/are is usually a pain in the butt. I don't know if it's just in my head but my pdocs have never liked telling me what they think is going on with me diagnostically speaking. If I ask they look almost physically uncomfortable with telling me!

Mine is the same way! At first he gave me a diagnosis of BP-NOS (a wastebasket dx if I ever heard one!) and depression; the depression dx went away last summer when he first saw me in a hypomanic state. BP-NOS stayed around until I finally asked him at the last visit what the hell kind of bipolar I really am. He said that the "diagnosis" part was actually more about how insurance companies pay doctors for their services, and hemmed and hawed for a bit: "welllllllllll......"

He still wanted to stick with NOS because I apparently don't fit into any neat little pigeon-hole, but admitted he doesn't like making a definitive dx anyway. He finally conceded that I'm somewhere between 1 and 2, but he leans toward 2 because the only manic/psychotic episode I've ever had occurred when I was on Wellbutrin a couple of years ago. However, he won't rule out BP 1 either........and round and round it goes. Maybe I'll never know!

[comicgeek007]

For me it was different docs at different times.

Trichotillomania at about 8-9 years old, behavioral T
Conversion disorder 9th grade, ER
TECHNICALLY I'm still listed as Mood disorder NOS cannot rule out Bipolar, but that's going to change very soon to one of the BP's.
Bulimia - last Thursday, current T

[ultramar]

Originally Posted by BipolaRNurse

Mine is the same way! At first he gave me a diagnosis of BP-NOS (a wastebasket dx if I ever heard one!) and depression; the depression dx went away last summer when he first saw me in a hypomanic state. BP-NOS stayed around until I finally asked him at the last visit what the hell kind of bipolar I really am. He said that the "diagnosis" part was actually more about how insurance companies pay doctors for their services, and hemmed and hawed for a bit: "welllllllllll......"

He still wanted to stick with NOS because I apparently don't fit into any neat little pigeon-hole, but admitted he doesn't like making a definitive dx anyway. He finally conceded that I'm somewhere between 1 and 2, but he leans toward 2 because the only manic/psychotic episode I've ever had occurred when I was on Wellbutrin a couple of years ago. However, he won't rule out BP 1 either........and round and round it goes. Maybe I'll never know!

Ugh, I just don't get these psychiatrists and their lack of desire to diagnose (re lack of desire to do their job). I've heard this from other people (and I think I posted about it some time ago). Psychiatrists are paid boatloads of money, and my understanding is that part of their skill-set is being diagnosticians. Also, if you're prescribing heavy-duty drugs, I think there's an obligation to explain why. I just think the attitude is a bit obnoxious frankly -anyway, I'm sorry about his hemming and hawing. From what these psychiatrists are saying, it sounds like if insurance didn't exist, they'd just never diagnose at all. I guess, as the platitude goes, if the treatment is helping you, the diagnosis doesn't matter.

[comicgeek007]

Originally Posted by ultramar

Ugh, I just don't get these psychiatrists and their lack of desire to diagnose (re lack of desire to do their job). I've heard this from other people (and I think I posted about it some time ago). Psychiatrists are paid boatloads of money, and my understanding is that part of their skill-set is being diagnosticians. Also, if you're prescribing heavy-duty drugs, I think there's an obligation to explain why. I just think the attitude is a bit obnoxious frankly -anyway, I'm sorry about his hemming and hawing. From what these psychiatrists are saying, it sounds like if insurance didn't exist, they'd just never diagnose at all. I guess, as the platitude goes, if the treatment is helping you, the diagnosis doesn't matter.

My T is just biding her time since I live in MD (at university in MS) and MD likes to play big brother and REQUIRES you to notify the MVA about any Bipolar diagnoses so they can decide whether you get to keep your license. It's annoying but she's trying to keep me out of dealing with that BS as long as possible.

[rossiv46]

I was originally diagnosed MDD and 2011 re Diagnosed with Bipolar 1. They changed it due to times in hospital and observations. Ive only had one Pdoc. After last episode I got a Therapist who is also a Dr and she gave me BP1 and talked to my pdoc and both have me bipolar now. I also tested for ADD and have that as well. I was given some computer test to rate how I pay attention. With my Pdoc we don't really talk much about dx. I just tell him I had panic attack or anxiety and he pretty just treats that with meds. I guess that's why it's also good to have a therapist who can help you deal with things and not totally relying on pills. Lastly Im an alcoholic and that one is just a give in.

[~Christina]

Comicgeek

If you have BP you can lose your license??? What ????? I have never heard of something so ridculous in my life !!!

wow , just wow

[comicgeek007]

Originally Posted by ~Christina

Comicgeek

If you have BP you can lose your license??? What ????? I have never heard of something so ridculous in my life !!!

wow , just wow

Yeah, if you can't get a doctor to sign off on you being in a good state to drive, they take it. And the doctor can send in something at any time to say you shouldn't be allowed to drive even if they had previously signed off on you.

List of "Reportable conditions" include:
cerebral palsy
diabetes requiring insulin
epilepsy
Multiple Sclerosis
muscular dystrophy
irregular heart rhythm or heart condition
stroke
alcohol dependence or abuse
drug or substance abuse or dependence
loss of limb(s)
traumatic brain injury
bipolar disorder
schizophrenic disorders
panic attack disorder
impaired or loss of consciousness, blackout, or seizure
disorder which prevents a certain range of vision
parkinson's disease
dementia
sleep disorders (like narcolepsy or sleep apnea)
autism

[wildflowerchild25]

I actually prefer not discussing my diagnosis because some doctors have reduced me to my dx. They don't listen to me because they already think I'' one thing. Also, I have met people in my psych ward travels that collect dx like badges of honor so they can prove that they are the most messed up. Mostly among the teens but I saw some adults do it too. Like at one point I was borderline, bipolar 2, generalized anxiety, social anxiety, anorexia, etc but ideal like all of those things may be manifestations of the singular illness of bp2. Although I am still struggling to admit that it may be a real illness I must contend with.

I know drs should tell people so they can learn about it but maybe some don't want the patient to take on the illness as their only identity.