First real bout of doubting the diagnosis.

Well, I've always waffled around with whether or not I really THOUGHT I had bipolar or not, so this isn't really a new feeling.

But it is the first time I've had thoughts of "What if..." popping into my head since the diagnosis. Honestly, I sorta started laughing at them, and then cringed as I imagined what my T would be saying.

The conversation would likely go as such:

"So, just to let you know, I've been having my first round of not really thinking this should be my diagnosis."
"L, it's common for people with bipolar to doubt the diagnosis. Trust me, you are bipolar."
"I KNOW it's common! But how can we know for sure? I'm on meds!"
"I've seen you depressed, and I've seen you hypomanic when I couldn't get a word in."
"Yes, BUT that hypomania was caused by the sertraline, it wasn't just normal!"
"Dr. P says you have bipolar L"
"Yes, well, Dr. P asked me very short questions and we only have my responses to go off of. How can he be sure that I'm able to accurately describe what's going on? What if my ups are really just imagined or an actual good mood? How can we be sure of that, when you'll never see it because I'm on these stupid meds that aren't doing anything!"
"Well, if they aren't doing anything then I suppose we'll find out."

......................

It sorta cracked me up. I sorta don't trust the pdoc more than I mistrusting myself - I still believe I have bp2... but how could the pdoc know?! He barely spent any time with me and how does he know that my perspective isn't totally skewed?!?!

I'm in that state right now...because I'm on the right meds. But I mentioned going off my meds to my hubby and he reminded me about how I am without them and it brought me back to reality.

As far as the pdoc KNOWING you're bipolar, he/she doesn't really know. Diagnosing MH conditions is all about matching symptoms and educated guesses. Since there's no physical test that can be done, they don't really KNOW, but we are Dx'd with the closest thing that fits. Hell, one more match and I'd have Borderline, not Bipolar.

Thanks AnxietyGirl - I think I just doubt the pdoc since he diagnosed me after meeting me once.

I think they see it enough that they can diagnose after only one visit.

Yeah...

I probably wouldn't doubt it at all if my hypomanias were a bit more reckless or something. Mine are quite tame, and are fairly close to "normal" behaviours..... My baseline is pretty darn low, so in comparison I know that I'm in a hypomania when I'm not feeling sad as my general state of being - fortunately I have my energy levels and sleep to help signify things for me.

I feel the same way. My highs just aren't that high, but my lows are really deep. How can my Pdoc be so sure based on self-reporting?

I hear you on the tame hypomanias Red Panda!

My hypomanias would likely be considered 'normal' for most of the population, but they are highly ABnormal for me. I get this confidence in myself & my endeavors that I never have otherwise, feel optimistic about the future, spend more but not a lot in the grand scheme of things, have more energy and talk more, want to socialise when normally I'm socially anxious. All stuff that's no big deal for most people, but is way out there for me.

I have my doubts sometimes but the pdoc who diagnosed me is an expert in bipolar and has been asked to help write the new NICE guidelines for bipolar, so I try to trust him. And it explains my huge shifts in energy cos usually I'm moderately depressed, then hypomanic, dysphoric hypomania, mixed, severe depression and back to moderate depression.

*Willow*

Whether his assessment is accurate or not, the reasons you question it are totally valid!

Very little time spent, a few questions, and bada-bing a dx?! If your hypo was in fact the caused by the sertaline.... the DSM specifically disqualifies this (substance-induced) as a criteria to base dx upon. It is also legitimate to wonder about the accuracy of self-reporting. Just ask a statistician, lol.

A "few very short questions" is troubling, isn't it? Please excuse, but it compels me to rant ...

Rant the first...That is the very thing that caused my initial mis-dx. As MDD. She undoubtedly felt she'd 'seen it enough' to consider it easy to dx. And, to ascertain the manic end of things? 3 words(!!!) "So, no highs?" I thought she was talking about drugs. I was in no state to self-report, or even realize I needed clarification/elaboration(!) Hell, I couldn't rub 2 brain cells together. If she'd asked someone else? The answer would have been a resounding, "OH yeah." Followed by voluminous elaboration, lol. My hypos are not subtle. Even slightly more responsibility in dx-ing would have easily uncovered that and saved a lot of hell.

Rant the second... Especially now, on account of computers, it would be all too easy for someone to memorize a list of symptoms that might well "pass" a cursory questioning. (This would anger me beyond the power of 10,000 suns, but surely it happens.) Not to mention people's tendency to self-diagnose and pathologize the ordinary. More in-depth interviewing would weed out a lot of that kind of crap.

A few short questions simply don't suffice in such serious matters! To your perturbation by it, hear hear!

My pdoc dxed me on one visit and I sometimes wonder myself, but never forget YOU ARE MORE THAN YOUR ILLNESS..

I doubted my dx for 6 years. I still do sometimes.

This summer my meds were working so well that I forgot how bipolar I was. I started thinking the doctor misdiagnosed me. I thought maybe it was just a hormone imbalance. I started coming off my meds and voila... I'm very bipolar. It was a good reminder, but it destabilized something that was working well. Now I'm on more meds than before and I have to rebuild trust with my doctor.

That's my story. I had to learn the hard way.

I just posted a similar post a few days ago. I completely agree - one short visit and a few totally unrelated questions and the pDoc said I was bipolar. I didn't agree then. Approx. thirteen years later and I take a test with T that suggests the same thing. *shrug* Still don't believe it. I think I have pretty tame hypomania as well, that or people around me are so used to it that they just kind of "let me do me" lol.

My Pdoc keeps emphasizing that I have serious bipolar and I shouldnt go untreated. I forget after a while and start talking about going off meds. Until I end up in the hospital it changes my mind and I remember oh yeah, it is that bad. Being paranoid manic plus psychotic is no joy ride.

Me too. I'm the same way. I deal more with depression than anything else, but because sometimes I do reckless stuff (like spending a lot of money) and I have a lot of irrational thoughts, (amongst other things), they classified it as bipolar.

For me, I sorta Dx'd myself. I'm a social worker, very familiar with the DSM, so I was able (during a stable period) to write everything down and take it to the pdoc for a "second opinion" of sorts. My husband (also a social worker) agrees with the Dx and so my pdoc asked me a bunch more questions and that's where I got my official Dx. I've suspected it for years, but was always afraid to label it.

Just now coming off one of those! I should've known I was ramping up last weekend when I was spending money like there was no tomorrow and thinking that I might not really be bipolar after all. I didn't try coming off the meds, but I probably would have if the episode had gone on much longer.

I would HATE to destabilize when it's taken me so long to get here. Dunno what brought on the hypomania, but at least this time I caught it before it got out of control, forced myself to go to bed earlier and take my meds per my normal schedule (instead of at 3 AM). Now I'm floating back down and landing softly in Middle-of-the-Road Land.

that's not the point. The point it that sometimes one's doubts are correct and just because it was a doctor who did the bad diagnosing doesn't mean it's true. Especially in something so free to interpretation as MH issues.

Thanks for the support everyone!

Overall I do totally believe that I have bp2. But I'm not a doctor, so how could I be sure. And I don't trust the pdoc anyway, and I question his method in diagnosising me within less than an hour.

Thanks!

The point it that sometimes one's doubts are correct

I think this is a good point, Venus. I often see on this forum a kind of automatic jump to 'denial' when this is surely sometimes the case, but there's no reason why it would have to always be the case.

In some cases it can be dangerous to question the diagnosis (i.e. abruptly going off meds), but sometimes I think it can be healthy and useful (whether doubts prove accurate or not) -it just depends on the person, the situation, all kinds of things.

Red Panda, you could go for a second opinion if you want to feel more secure in the diagnosis. Regardless, it sounds like your treatment is helping you and that's the important thing. But the option is there to seek maybe a more thorough, if not two or three-part evaluation by another pdoc (I think insurance covers this, but I guess it would depend on the insurance), which doesn't mean, of course, you couldn't go back to your current pdoc.

That's the problem with being mentally ill. No one believes you when you tell them how you feel

I think you're instincts are correct that some doctors are better than others. Even in crazy mode, I could tell my pdoc at the hospital was a hack. But what I did in crazy mode proved I needed some form of medication: I palmed the pills they gave me every night because I thought it was poison.

The point I'm trying to make is that it's great to get second and third opinions, preferably with doctors that use different methodologies. Eventually you'll find a person (person) you trust, and the meds will magically become easier to take everyday. Even if for whatever reason you're not making the best decisions that day.

Imho, if you are really bipolar, doctor should be able to point out symptoms. If they say something like "you are bipolar cause I am a doctor and I diagnosed you"... seek second opinion. Any doctor that treats you as "you are crazy, I am doctor" can do more harm than good.

Exactly!

Good point, Venus. Pdocs should be explaining to patients why they are making whatever diagnosis they are making (not just bipolar); they should be able to back it up, based on what the patient has reported, their own personal experience (assuming they have enough), the most current research (not just the DSM, because it is 'updated' in some ways all the time through a lot of research conducted in the interim between DSM publications), and last but certainly not least, their observations of the patient over time, which I think is important and why it can take time.

But unfortunately, both from my own experiences, and from what I read of some others, a lot of pdocs are not great communicators. If nothing else, this often means that it's up to the patient to ask the questions, make sure they're answered, bring up concerns, etc. Who knows really what goes on in these people's heads? -Sometimes we have to drag it out of them. I think that's one of our roles, anyway, in the pdoc-patient relationship, for better or for worse, fair or not.

Im having doubts again today, I cant remember my hypos today, I cant remember what I was like or what it felt like, so did it really happen? How do I know I wasnt just faking it or just happy for not being depressed? Guess its time to have a big chat to my partner tonight again.

Do you journal? Though it's not mood tracking, per se, it's a possible way to track how you have been doing over time. Even if, in your journaling, you're not labeling yourself in x mood, you may well be able to tell by how and what you're writing. It's been very helpful to me, both in the moment, and to look back sometimes -not just noting moods, but other things, thoughts, events, emotions, etc., helps to give me perspective on things in general, since memory, at least for me, can be capricious.