[Wander]

My psychiatrist has removed my Bipolar diagnosis despite admitting in a hospital discharge summary that I have 'a consistant pattern of elevated mood, depression and mixed features'. He is continuing my BP meds as they treat my symptoms well. At the moment my diagnosis is Complex PTSD, mood dysregulation (didn't even know that was a diagnosis) and possible ADHD. He wants to move my treatment from that of a mood disorder to that of an anxiety disorder (PTSD). I never had a chance to chat to him about this as he handed it to me just before our session ended. I am so confused as my PTSD is relatively under control and my mood is the problem.

To add to my confusion my T (who is trained in diagnosis) totally disagrees with my pdoc and says I definitely have Bipolar and it is my main diagnosis over Compex PTSD. He says my main problem is all about my mood. It is what always lands me in hospital, not anxiety. And I have been in hospital a lot. He claims my pdoc is not making any sense and I tend to agree.

So do I or don't I have Bipolar now?? Does it really matter? Is it not all about treating symptoms anyway and at least my pdoc is doing that well. This has really thrown me although my mood is still a solid happy since a med change last Saturday. There is definitely a biochemical element to my illness along with the PTSD. I am a bit lost right now. What do I do? I am seeing my pdoc in two weeks so I can discuss it with him then but I am a bit anxious about it to be honest.

[candid_spectrum]

Well I'm not a trained professional. So here are just my opinions, in the US the diagnosis matters a lot, for things like hospitalization, disability and other such clerical issues that really effect day to day life's of suffers. If your still on your BP meds, then to you personally it should not affect today, but in terms of treatment it will I would talk to your therapist about maybe suggesting a new pdoc, if you talk to him and he/she doesn't justify the switch. Best of luck!

I agree with candid_spectrum: Try seeing a new pdoc to get a 2nd opinion.

Regardless, it's still worth seeing your current pdoc in 2 weeks to hear his explanation. Right now you're a bit confused (and I would be too), so it'd be helpful to learn from him. Then you can discuss his findings with your T and your new pdoc.

BTW, I'm not saying you have to leave your current pdoc in order to see another pdoc. You can always find a new pdoc and tell him or her that you're looking for a 2nd opinion. Then once you get your 2nd opinion, you can choose which pdoc you want to stick with.

I've done this before (mostly because I was in denial about my BP), and the 2 ended up agreeing on BP.

[Gabyunbound]

That makes no sense to me. He seems to be describing classic BP symptoms and then goes on to say 'mood dysregulation' (isn't that BP?), If he had written 'emotional dysregulation' I'd think BPD, but he doesn't. Though Complex PTSD, I believe, has similar symptoms to BPD. But, as you say, it just doesn't make sense, especially since the first things he writes are just classic BP.

I'd talk to your pdoc first and give him a chance to explain himself and you to get your questions answered, and if you're still not satisfied, look for a second opinion.

Best of luck, you don't need this uncertainty right now, though I'm so glad you're feeling so much better after the hell you've been through!

[Wander]

The thing is that apart from this issue (which is a big one) I have a great relationship with my pdoc. He has been very skilled, compassionate, wise and caring. I was only recently singing his praises in a post. He has fought for me and never given up on me even when I had lost hope. This has been a shock. I never expected him to doubt a diagnosis he himself gave and confirmed over and over.

It will be very difficult for me to drop him and even more difficult finding someone else. I would no longer be able to go to the hospital I have been going to for the last 6.5 years as there are only a few pdoc's attached to the hospital and they are very close so none would take me. Also simply finding a decent psychiatrist is one hell of a mission. My condition has been severe so I really need the right care. My current pdoc gets this. The diagnosis issue has just thrown me and taken some trust away between me and my psychiatrist.

[Wander]

Originally Posted by Gabyunbound

That makes no sense to me. He seems to be describing classic BP symptoms and then goes on to say 'mood dysregulation' (isn't that BP?), If he had written 'emotional dysregulation' I'd think BPD, but he doesn't. Though Complex PTSD, I believe, has similar symptoms to BPD. But, as you say, it just doesn't make sense, especially since the first things he writes are just classic BP.

I'd talk to your pdoc first and give him a chance to explain himself and you to get your questions answered, and if you're still not satisfied, look for a second opinion.

Best of luck, you don't need this uncertainty right now, though I'm so glad you're feeling so much better after the hell you've been through!

I know! Mood Dysregulation is like BP. Emotional Dysregulation would not have seemed so out of place (considering his rejection on BP) as you are right that Complex PTSD has a lot of similarities to BPD, and I have been previously diagnosed with BPD which this pdoc overturned in favour of BP. It just doesn't make sense!
Good idea about giving him a chance to explain himself first and thanks for being happy for me. I certainly have been through hell this year, especially the last month. In fact I feel traumatised from it all.

[BeyondtheRainbow]

I can tell you that until my PTSD was treated my bipolar was very different than it is now. Treating the PTSD decreased the rapid cycling (even in the 2 year episode I've just ended I didn't cycle like I used to) and just made things better (even though I was very sick for a long time; it was different but I don't know how to explain).

I went through a therapy specifically designed for PTSD and it was very hard but very worthwhile.

[Wander]

Originally Posted by BeyondtheRainbow

I can tell you that until my PTSD was treated my bipolar was very different than it is now. Treating the PTSD decreased the rapid cycling (even in the 2 year episode I've just ended I didn't cycle like I used to) and just made things better (even though I was very sick for a long time; it was different but I don't know how to explain).

I went through a therapy specifically designed for PTSD and it was very hard but very worthwhile.

Thanks for the input. I think that is my psychiatrists thinking except he ditched the BP diagnosis. I was constantly rapid cycling and mixed (stable now but who knows how long that will last) so if treating the PTSD helps then I am all for it. Sorry you were so ill for so long. How are you now?

[BeyondtheRainbow]

I'm much better thanks. I had just maxed out on all the "good" meds. I'm on clozaril now and while I'm impatient to have been well long enough to try reducing the dose (I have no motivation on the moderate dose) I feel better than I have in a really long time. This episode was partially triggered by my PTSD getting aggravated after a long time of not struggling with it much (something extremely triggering happened) and then there just weren't good med options. But I've been on the clozaril 5 months now and have probably been more level than ever before, just LAZY.

I hope that you have finally found the meds that will do the same for you. You've been through way too much in the last year (?) or so. Modanfil did great things for me when I was working. Now I take it PRN to overcome the sedation if I need to be more functional. I think I need to take it routinely but am scared for some reason.

I don't know why your pdoc dropped the bipolar. I know that here sometimes they fill out discharge papers really quickly and things show up that are odd. Like I was discharged in February with a diagnosis of severe depression.Not bipolar severe depression, just severe depression. It was a mistake and my pdoc said nothing else was marked that way but the official form was wrong.(To be fair the unit I was on had 9 depressed patients and one bipolar patient so they probably get used to writing depression).

[Wander]

Originally Posted by BeyondtheRainbow

I'm much better thanks. I had just maxed out on all the "good" meds. I'm on clozaril now and while I'm impatient to have been well long enough to try reducing the dose (I have no motivation on the moderate dose) I feel better than I have in a really long time. This episode was partially triggered by my PTSD getting aggravated after a long time of not struggling with it much (something extremely triggering happened) and then there just weren't good med options. But I've been on the clozaril 5 months now and have probably been more level than ever before, just LAZY.

I hope that you have finally found the meds that will do the same for you. You've been through way too much in the last year (?) or so. Modanfil did great things for me when I was working. Now I take it PRN to overcome the sedation if I need to be more functional. I think I need to take it routinely but am scared for some reason.

I don't know why your pdoc dropped the bipolar. I know that here sometimes they fill out discharge papers really quickly and things show up that are odd. Like I was discharged in February with a diagnosis of severe depression.Not bipolar severe depression, just severe depression. It was a mistake and my pdoc said nothing else was marked that way but the official form was wrong.(To be fair the unit I was on had 9 depressed patients and one bipolar patient so they probably get used to writing depression).

Thanks Rainbow! I am so glad you are feeling much better. It is such a gift when it comes. I have cautious hopes for my new med regime. Glad to hear Modafinil worked for you too. I am hoping it will help me with work and study. I doubt the absence of BP was a mistake as he added 'Mood Dysregulation' for some reason, which really is the same thing I think. I will ask him when I see him.

Originally Posted by Wander

My psychiatrist has removed my Bipolar diagnosis despite admitting in a hospital discharge summary that I have 'a consistant pattern of elevated mood, depression and mixed features'. He is continuing my BP meds as they treat my symptoms well. At the moment my diagnosis is Complex PTSD, mood dysregulation (didn't even know that was a diagnosis) and possible ADHD. He wants to move my treatment from that of a mood disorder to that of an anxiety disorder (PTSD). I never had a chance to chat to him about this as he handed it to me just before our session ended. I am so confused as my PTSD is relatively under control and my mood is the problem.

To add to my confusion my T (who is trained in diagnosis) totally disagrees with my pdoc and says I definitely have Bipolar and it is my main diagnosis over Compex PTSD. He says my main problem is all about my mood. It is what always lands me in hospital, not anxiety. And I have been in hospital a lot. He claims my pdoc is not making any sense and I tend to agree.

So do I or don't I have Bipolar now?? Does it really matter? Is it not all about treating symptoms anyway and at least my pdoc is doing that well. This has really thrown me although my mood is still a solid happy since a med change last Saturday. There is definitely a biochemical element to my illness along with the PTSD. I am a bit lost right now. What do I do? I am seeing my pdoc in two weeks so I can discuss it with him then but I am a bit anxious about it to be honest.

I am no expert, but you seem to have bipolar based on what you've described here.

My T thought I had schizoaffective and that freaked me out. I talked to my pdoc and he disagreed as my psychosis only happens during a mood episode. I agree with my pdoc.

My pdoc says it's most important to treat the symptoms. He said that is more important than labels. I understand you wanting to know, however.

Just hang out with us here. Try not to worry. If it is really bugging you, see another pdoc for a psych evaluation and see what they say.