How do I make my T listen to me?

I have a T (and possibly the worst pdoc in this city), but they do not want to hear me explain why bipolar II is my main issue. This is where most of my problems and almost all my pain comes from, but they call it a "fuzzy diagnosis" (I tell them "OK, but my problems are not fuzzy and they're plainly in that category"), and they just wanted to listen to me for like 20 seconds while I explained what hypomania felt like before they changed the subject (I mentioned some peripheral symptoms and not the central ones that are part of the diagnosis). I could've lectured them for hours, but they don't want to hear about it. They say I am in a psychosis risk group (I do not think I am at risk) and have schizotypal (not a PD in ICD), and they seem to believe these are my main problems. How do I make them actually listen to me? I REALLY do not want to quit all my meds again and then go inpatient like they suggested (I've never been in inpatient care) so they can see how unstable I get. I feel that being med free will destroy my brain. It shouldn't be so difficult, someone has already diagnosed me with bipolar II, but these guys do not want to even discuss it properly. They just talk about how diagnosis is not that important and then switch subjects. I don't need them lecturing me about what is important and what's not, I am more than capable of figuring that out on my own. This is provoking me to the point where I want to give up all therapy and pdocs until my unemployment benefits stop and I actually need my diagnosis. Any suggestions, please?

In my experience pdocs tend to know what they are on about. I would listen to their advice. Sometimes when we are mentally ill what we think is the problem and what really is the problem can be different things. Just because one doctor once has diagnosed you does not mean this diagnosis is correct, it can take a long time to get a correct diagnosis but the important thing is to keep on working on yourself and continue your medication.

This one does not. I am not stupid, I know what's going on. The diagnosis is correct, and this wasn't supposed to be a discussion about my diagnosis. Sorry if that was harsh, but I'm sure you can see why I'm a little ticked off.

I am on an up cycle today and have a very short fuse.

Edit: Oh, and two pdocs and one T made the diagnosis. This T and pdoc are new and I have had about 4 and 1 appointments with each, respectively.

The diagnosis doesnt really matter, being complaint with your treatment does.

I will be with the meds, but I will not go to a therapist or a doctor that doesn't want to listen to me. And the diagnosis does matter for my benefits.

I dunno because I have dropped my pdoc and t for generally not listening to me or not being able to help me, or not letting me decide what I need.

I will say this.. you likely know yourself better than anyone. Could you tell your T that you feel unheard and that is not working for you. These people are "supposed" to be working for you. Providing a service, they are also getting paid for that and probably quite well. I don't know if you have laid it out to them how you are feeling about your care. From my own experience the best type of patient/dr/t care comes from working together as a team and not from the perspective of dr in charge...power imbalance point of view. Doesn't leave much room for the patient to be pro-active in their own care,which trickles into other parts of life.

Other than that you could set out to find a pdoc or T who will value your input and welcome your participation in figureing out what you need help with.

I get it tho, been there and no it doesn't feel good...sorry

Thanks, this was really helpful! No, I've tried to explain that I'm not what they think, but I haven't laid it out to them how I actually feel about all of this. I think I will tell them that this isn't working, that I need them to listen to me more, and to take what I say seriously without doubting my motivation for listing some symptoms, maybe the "wrong" symptoms, or whatever it is they're doing. If this doesn't work I will definitely find a new pdoc, but I might stop therapy for a while.

Unfortunately countries using ICD are less prone to diagnose vague cases of bipolar, they still live in the time where it was manic depression or something else. Manic depression is the severe form called BP1 today. Some do not really believe in BP2, bipolar without mania. Some people want it to be like in the old days, clear bipolar (with a lot of mania), schizophrenia or depression.

I think that is why I "am" depressed and not bipolar in the ICD using country I live in. I have hypomania. But still I am seen as depressed because they don't want to "overdiagnose" bipolar as they say they do in USA. They are very critical to how bipolar is diagnosed in USA.

So when I talk from here to USA, bipolar is not the same thing. Not in the eye of the doctor. It is important to remember that. Most who would be BP2 in USA are depressed here and treated without mood stabilizers.

I wish it was easy to just get a new doc. Many times then I would just walked out when it was suggested I had things I didn't have, based on my body language (and told I did not have things I had). They look at me how I speak, how I sit, how I dress. They do not so much listen to what I say.

Some people are better at explaining with words and docs sometimes need to respect that.

Thanks jimi! They put me on 10mg zyprexa (now 20mg abilify) and 200mg lamictal for it but they don't all admit fully that there is a bipolar 2 or that I am there (talking about these new guys, not the previous ones). I don't know how well-defined bipolar 2 is, but I do know that I am bipolar and not bipolar I. My hypomanias are more intense than my depressions now, I know I'm not imagining things.

I feel confident that I will sort this out now. If they don't listen to me it's fine, I can find a new doctor.

I sorta got stuck on this part. But pardon me? Did they actually suggest that, or are you guessing that's what they'd want?

If someone was to say to me that they wanted to see how unstable I could be... I wouldn't see them again. The point is to try and see me stable as often as possible!

What symptoms are causing you problems? They really should try and listen to you. Are you actually listening to them? It sounds like neither side is really listening to the other one. Why do they think that you're at risk for psychosis? Why do you feel/think that your other symptoms are a bigger concern than that?

No, the previous people who treated me already took me off my meds to see if I was bipolar or not, and they found out that I was and gave me a diagnosis. These new guys don't want me off my meds, because of the psychosis risk. When they took me off my meds the last time, they wanted me to go inpatient (I refused), so I think that's what they'll want to do again when my unemployment benefits stop and I need a diagnosis, which as of now I don't have (because you need a diagnosis, not just a list of symptoms, to get disability benefits here). I'm not trying to get disability, I'm just trying to be realistic. I probably still won't be working in 2 years.

I'm trying really hard to listen to them, and when I'm there it's fine and I understand them well. When I'm home I get frustrated and angry again.

The reason they think there's a risk for psychosis is that I can get mild delusional thoughts during hypomania, I have some mild hallucinations and illusions, etc. when not medicated, and I have some "weird" thoughts and magical thinking. The reason I think this isn't my main problem is that this is mostly just a problem for me when I'm hypomanic or very depressed, so I think much or most of it might be caused by the bipolar. And otherwise these psychosis risk symptoms don't bother me that much, and I don't think they're that serious.

The symptoms that are bothering me a lot are the bad sides of hypomania, my depressed periods, and the avolition that I also have when hypomanic and when not depressed. I've told them all this a few times, but maybe not as specific as now.

Thanks for your reply!

From what I understand (and I might be wrong on this) is that psychosis is only there in bipolar 1. At least according to the DSM. But then again, mixed episodes according to the DSM IV can only be in bipolar 1 and we know that that is changing in DSM V. I'm not sure where psychosis lies.

If the psychosis is present only during your episodes of hypomania and depression, and you're only having troubles with the bad sides of hypomania and depression..... umm... that sounds like you're all concerned about the same things

Why not ask if during the whole debate they diagnose you bipolar NOS or bipolar with schizoid/shizoaffective features (I'm not sure of the difference) or one of those with bipolar features.

Most who would be BP2 in USA are depressed here and treated without mood stabilizers. Jimi all bp whether 1 or 2 is treated with mood stabilizers here. It was a disaster when my husband was given just anti-depressants. He was in a continues mixed state.

Axiom,
I'm a person that needs constant reminder why to take meds. I have talked about my Dx. 3 times in 3 yrs. all the other times it was brushed over. My therapist is very vague. First meeting with pdoc he told me my dx. First meeting with T she asked why it said with psychosis. Like I'm suppose to know why. Later I pushed her and she read me what the computer said. Recently I pushed her again because I'm moving and needed it for my new team. She was going to read off the again and I told her no I wanted her opinion. She still weaseled out of it but I enjoy her ability to do that. She did tell me what to put on the paper. I would say you want to start filling out your claim for disablity and needs to know your Dx.

I'm aware that BP2 in USA are treated with mood stabilizers. What I am saying is that someone who is on the lower end of BP2 in USA will NOT have a diagnosis of bipolar where I am, they will have one of depression. And it does sometimes lead to crazy things, like my friend who was seen as depressed and really bipolar undressed in public (on SSRIs only).... It's like you have to PROVE yourself to be bipolar here.

You also have to have more hypomania or mania to live up to BP in ICD compared to DSM. I am not BP2 in ICD but I am in DSM because my too short hypomanias. Get it?

Luckily I am near enough the cusp that I actually do not need stabilizers, I do well on just an antidepressant.

Also over here bipolar isn't seen as ground for psychosis. They simply don't believe that when your mind speeds up you can experience crazy things. They want that to be schizophrenia. Almost all psychotic episodes are seen as schizo here. Now I should say I am NOT in the same country as Axiom, but I believe we share a bit of diagnostic culture.

I don't know how it is where Axiom lives but over here you can get sick leave (long term) for BP but not for depression. The rule here is longer sick leave is only for diagnoses that are always life long. I do not know if they have the same crap over there but would explain a few things. At least he says he needs a proper DX for the sick leave. Docs here would fight that because they are told not to give people time off "too easily" and perhaps it is the case there too, which could influence what diagnoses they want to make. Make one, he gets sick leave, make another he does not. Then it is about politics not medicine. Schizophrenia would probably give him sick leave but then his further treatment would be based on a lie. Not so good....

I have also been tossed between doctors who have not agreed on diagnoses. It is incredibly frustrating, especially when you feel in your heart they finally found the right one and then someone wants to take it away.

Sigh.