[BeyondtheRainbow]

I have, without a doubt, severe bipolar I. I've had the diagnosis for many years and all my doctors agree and are quite firm about this. BPI with dysphoric mania and frequent mixed episodes.

Somehow I left the hospital with a lab order saying I was there for severe recurrent MDD. I did have severe recurrent depression in the context of bipolar but I am definitely bipolar. I don't know if this was an error or if the resident who I thought was so great wasn't or what but I can't wait to see my pdoc Monday to find out why they would even consider changing things at this point.

[Wanderlust90]

I love how the change a dx based on a single episode when bipolar by definition is a cycle of episodes. Too often I see ED docs dx schitzophrenia for ANY kind of psychosis, drug induced being the main one, even on first episode psychosis. I mean I know the ED dx means **** when your then transferred to IP but still. It's not like they couldnt fill in the dx as psychotic episode. Likewise they shouldn't be saying you have MDD for risk of some other stupid dr thinking it's ok to load you up on ADs if you ever need to go to ED.

[BeyondtheRainbow]

Well, if they gave me ADs I could sue them because I'm on an MAOI.

I'm pretty certain it was just a mistake. The diagnostic codes have just changed so they'll be getting used to them and he was doing 3 discharges all at once and I have a feeling someone else is wondering why their lab order says bipolar when they have MDD. It is my name and needed lab but I have a feeling he was just going fast and put the wrong dx. My pdoc works in the same hospital system so she'll fix it easily.

He was just too good a doctor to miss this and I know my dx IP was bipolar; there was a facesheet thing on the med computer and it was easy to find me because I was the only bipolar in a sea of MDD. (which could also contribute to a mistake).

My guess is that he meant to use bipolar depression severe and then went auto-pilot.

No big deal, just a little shocking at first.

[Wanderlust90]

Oh fair enough, so long as it's a mistake that can be fixed, it's understandable. Your dr sounds much better than many I have worked with!

Originally Posted by BeyondtheRainbow

I have, without a doubt, severe bipolar I. I've had the diagnosis for many years and all my doctors agree and are quite firm about this. BPI with dysphoric mania and frequent mixed episodes.

Somehow I left the hospital with a lab order saying I was there for severe recurrent MDD. I did have severe recurrent depression in the context of bipolar but I am definitely bipolar. I don't know if this was an error or if the resident who I thought was so great wasn't or what but I can't wait to see my pdoc Monday to find out why they would even consider changing things at this point.

Hm. You know yourself better than anyone else does, but I'll try to rationalize the hospital's thought process.

There is such a thing as "psychotic depression". See here: https://www.nlm.nih.gov/medlineplus/...cle/000933.htm

You do not have to be bipolar to experience psychotic depression. In fact, "psychotic depression" is a subtype of major depression and it looks a lot like a mixed episode.

If you do not experience mania by itself, then it's possible you *do* have MDD, psychotic depression subtype. I think that's the hospital's logic.

So... it may not be a mistake at all.

If ADs make you manic, then you're probably bipolar.

[BeyondtheRainbow]

I understand that the hospital could have diagnosed me with depression. But I have a bipolar diagnosis that is very well-established and for very good reason. It is not up for debate; it might have been 15 years ago but by now we know.

I don't have psychotic depressions; I have definite mixed episodes and have for years. ADs make me tremendously manic and I get manic on my own. I cycle frequently and my drs. know me well. I know mysel well. They will laugh to hear that this diagnosis was given after what I've been through over many years. I am very, very, very bipolar which really struck me as humorous when I posted this. There is no way to explain much of what I have experienced it the last 25 years without bipolar. I think the people who know me on here probably can smile at this diagnosis b/c they've been here through months of uncontrolled bipolar with me.

And this hospitalization was not the time for diagnostics. I went in because I had to get off a very high dose of Seroquel and go onto another AP. My brain was a mess as was I. This wasn't a diagnostic stay nor could they have really diagnosed much since I was being made much sicker for a while by what I was going through and I was also pretty heavily sedated through about a week of it. I suspect that a resident who'd never been through this particular situation before saw that I spent all my time curled up in bed, often just staring at walls for a number of days while my brain was re-setting (and b/c I was on a lot o meds for anxiety and changing to the new AP), and thought it looked like depression. Which it did, just bipolar depression. And then, like I said, I think he put down the wrong code since the codes are so new to everyone.

Whatever, it's just funny to think anyone could know me and not realize I'm bipolar.

[Polibeth]

I wouldn't sweat the diagnosis on a lab order. I worked in a lab and no one is paying attention to the dx, it's just for insurance. As long as your pdoc knows you are bipolar - all is well.

[raspberrytorte]

I always find it entertaining to read what the IP doctor writes for my diagnosis. I've decided I always look mixed in the hospital because by that point I'm always so overwhelmed by whatever landed me IP in the first place I always am scary angry than spend some time bawling. I've never been depressed, so don't get the mixed thing. Whatever!

[BlueInanna]

I've heard of this before. I think it was about what that doc during that time observed only. Hope it doesn't affect your coverage?
Sorry it's caused you stress you didn't need that.

[BeyondtheRainbow]

Like I said, mostly I think it is funny. I just don't know what happens when I have my social security renewal and they see a different diagnosis. But my pdoc will fix it so my primary is bipolar and since she's the director of residency my resident may hear about it. Mostly though I just think it was a handwritten typo. I'm sure nothing has changed.

I want to get my hands on the discharge stuff. I used to get a paper saying my diagnosis, days I was there, etc. Now they fax all that to my therapist along with my evaluation reports and who knows what all. I suppose I could ask him to see it but it's probably healthier not to. So many people will have been documenting my "refusal to come to group" or "sleeping through group" because they didn't know I was ok to skip and that I did sleep a lot but that was intentional, etc. The clinical staff knew but I'm not sure the techs did.but its over and probably not much worse than any other time.

And again, I'm laughing, not worrying about this. I want it fixed if it is in the computer as a main diagnosis but Know how to do that. So it's just funny think of going back that many years before I was diagnosed. It also just shows the resident still needs to hone his skills which I'm sure takes years of practice, just as it did for me in my job.

[RomanJames2014]

I was originally diagnosed with major depression, OCD, and anxiety back when I was 18 because I didn't tell everything about my bipolar. I only explained the sad depression because that's all I thought was wrong. My doctor thought that it was more over a nervousness instead of bipolar.

Fast forward to last July at the age of 25, I started seeing a therapist through school and she recommended someone at Northwestern here in Chicago and a psychiatrist knew I had bipolar after explaining why my therapist sent me.

Sent from my iPhone using Tapatalk

[BeyondtheRainbow]

I know I have bipolar. I've been being treated for it for 14 years and have seen some of the top drs. in the field for diagnosis because it was hard for anyone to be sure of the diagnosis initially and then I was in a clinical trial. I know that the drs. who treat me are very sure as well. I just was startled to see that I was diagnosed with anything else besides bipolar 1, PTSD, GAD and OCD features because that's all I've been diagnosed with in many years.

I'm interested in what my pdoc says tomorrow. I think if anything the resident made this mistake (if not a typo) because I cover extremely well and I may have covered enough that he missed it. I barely left my room the whole time I was in the hospital so there weren't the usual behavioral cues to pick up on except when I was pacing which tended to be not when the resident was around.

I'll see how hard my pdoc laughs tomorrow.

[Ocean Swimmer]

Good luck tomorrow. Keep us posted.