Can't diagnosis if drinking

So you all know I had 13 months sober and then relapsed this Dec. During that time of sobriety I did have some rapid cycling and mixed states that were awful. I did not get zippy manic or down in a hole depressed. I was treated with BP1 meds bc that was what I was dxed last with. (ugh, sorry I just ended a sentence with a preposition.) Anyway I have been dxed with BP1 three times, BP2 twice, Major Depression twice, Dysthymia once, Cyclothymia once, ADHD once, Alcoholism six times, Anxiety and Panic three times, BPD once.

My t said she didn't Bp or BPD in me, only Depression so I asked the Dr. at the hospital and he said, "You have to be SIX MONTHS off all alcohol and street drugs to get a correct diagnosis. If you are drinking and go get a dx you will be dxed with Bipolar. Because drinking alcohol produces the same symptoms as BP. And that doesn't mean actively drinking on that particular day you go to the Dr. Maybe you had a few scotches three days ago and a week before that got drunk on a 12 pack. Then you are moody and unstable and go find out what is wrong and you get copped with a BP dx. And it's wrong!

Have I been dxed at 6 months sober, no, because I didn't need to. I thought I was already dxed correctly and didn't think about questioning it. My issue is this. Dx is important to me bc it tells me what meds to be on. I've been struggling with depression of late, and because being dxed BP I wasn't given any ssri's because of the mania concern. Now I am on ssri's and what if it makes all the difference and my life could have been so much better this last year had I known it was ok to take ssri? My current pdoc says he doesn't give out dxes. He just treats the patient with meds, wherever they are. I like this outlook in a way. It doesn't block me in but it also limits my understanding and connection to others who share a common peril.

If he doesn't give out dx's and only treats empirically that way, you could pretty well figure out your own based on what works for you, for the most part... unless it turns out to be an antipsychotic, and then all bets are off, but it doesn't sound like that's the case for you.
My doc is kinda the same way... his attitude is who cares what form of BP you have? We just need to find the right meds for you. It was helpful to have that starting point, though.

One other thing... I've never heard a doc say that about sobriety... I've often heard the opposite. The two things are so interlinked that you could almost makes a dx based on drug of choice...

Really, on drug of choice? What if one liked alcohol, pain pills, benzos, fentynal patches. Downers, that sort of thing? I don't like pot, or meth or coke or crack or adderall or speedy stuff or hallucinagenics.

It's virtually impossible for someone to get a correct diagnosis and stability while drinking or on street drugs.

I've also heard that about not getting a good diagnosis until you've been sober a yr.

Do you want to give up liquor?

The two are frequently interlinked, though, which makes things challenging. A large number of the people we treat are dealing with, for example, schizophrenia and meth addiction. I didn't mean a dx should be based entirely on that, just that I've personally witnessed some patterns working in the field. It is difficult to sort out what's what, though, because street drugs and alcohol generally tend to affect people differently. Another example, though also anecdotal, my sister actually somehow manages her bipolar disorder with weed (???). Weed makes me hallucinate and I can't stand it.

Oh - to add a little more personal experience I probably shouldn't - I am a former heroin addict. I currently take a lot of (prescribed) benzos. I tend to run manic about 80% of the time. The drugs I chose were almost always pure downers, because mania is exhausting and I constantly felt like bursting out of my skin. Other things usually just made me psychotic.