[Icare dixit]

If you could be tested for BP and it may be proven (conclusively) that you have BP, but not that you don't have it, would you want to be tested?

What if testing negative would mean you would no longer receive treatment for BP as a result? Let's assume, in this particular scenario, that the chances of testing negative even though you have BP are negligible (but there still is a chance).

[rwwff]

1) Sure, potential for added certainty would be nice, as long as it isn't too expensive.

2) No. The meds have greatly improved my quality of life compared with last year and before. If it comes with a proviso of pulling the plug on something that is working, even if it is working to treat something unknown or different?? Seems like a high cost low reward choice. Heck, I don't know that I'd be let back in the house if I were "off my meds" as it were. I used to be a royal pain in the butt to live with.

[Icare dixit]

That's a very rational way of looking at it. Even though it's certain to give you more certainty, wouldn't it potentially make you feel a lot less certain? Can you trust yourself to (always) be so rational? It's a risk. Does it really matter if your treatment is successful?

[benzenering]

I would want to be tested. I have questioned my diagnosis with my pdoc for years. She has me on FOUR medications which I cannot get off by myself. I blame my mood swings, mostly depression, on the meds she prescribes to me. I have a second opinion, which I find out tomorrow.

[Icare dixit]

And let's assume that if you test negative, you are more likely to receive better treatment (which is not just an assumption if you assume there is always a proper treatment for every problem and that after you test negative for BP, it's more likely you will be diagnosed correctly).

What if all false negatives, those that do have BP while testing negative, still need alternative treatment. That would make sense.

[Icare dixit]

Originally Posted by benzenering

I would want to be tested. I have questioned my diagnosis with my pdoc for years. She has me on FOUR medications which I cannot get off by myself. I blame my mood swings, mostly depression, on the meds she prescribes to me. I have a second opinion, which I find out tomorrow.

What meds are you on?

Testing would be nice.

I presume the testing would include more than just a Dx, though. That is, if testing could diagnose the condition, you'd probably be able to find other useful information such as how your individual brain chemicals change. (I mean, you'd probably have to know that information in order to make the diagnosis anyway.) Knowing individual brain chemistry would probably help us figure out which meds might work best, BP or not. Basically, genetic testing, only more accurate.

So in theory, it'd probably be super expensive! And I don't know how invasive it would be.

I actually think it's quite possible to do this already though, but the diagnosis process wouldn't be so practical. It's probably a matter of monitoring brain activity (neuron firing) and brain chemical changes on a daily basis waiting for a chemical imbalance to occur. So... brain monitoring for X many days in a row. Lotsa money

[benzenering]

Originally Posted by Icare dixit

What meds are you on?

Vraylar, lithium, lamictal, and propanolol.

I am thankful she is finally encouraging a second opinion. Doctors can be pompous asses. Second opinion included a psych evaluation...I am very interested in the results. It has taken me several months, though, to make the followup appointment...just a little nervous to see what the psychologist has found.

[franz kafka]

I would get tested. Though I'd be quite confused if the results were negative.

[Icare dixit]

Originally Posted by bluebicycle

Testing would be nice.

I presume the testing would include more than just a Dx, though. That is, if testing could diagnose the condition, you'd probably be able to find other useful information such as how your individual brain chemicals change. (I mean, you'd probably have to know that information in order to make the diagnosis anyway.) Knowing individual brain chemistry would probably help us figure out which meds might work best, BP or not. Basically, genetic testing, only more accurate.

So in theory, it'd probably be super expensive! And I don't know how invasive it would be.

I actually think it's quite possible to do this already though, but the diagnosis process wouldn't be so practical. It's probably a matter of monitoring brain activity (neuron firing) and brain chemical changes on a daily basis waiting for a chemical imbalance to occur. So... brain monitoring for X many days in a row. Lotsa money

It's not possible to measure/monitor brain chemistry. If it were, it would maybe work as you described, but even then it's hard to know what causes what, the aetiology.

At the moment, the best we can do is measure energy consumption, which is a rather crude guess as to which neurons (and glial cells) are firing at any one time. We have no idea how cells communicate exactly, we only know quite a lot about the medium, but not the "language", and we don't know which individual neurons communicate with other neurons (sometimes over long distances).

It's like a radar image of clouds and temperatures.

Nevertheless, if we'd define what BP is based on what we can measure, at least it could be proven that one has (or doesn't have) BP.

Maybe people are too much focused on finding a cause without actually knowing the effects.

A galvanometer on the skin and an ECG might be interesting to use at first. Maybe then a simple EEG that fits into a hat.

I wouldn't use MRI or fMRI because it's simply not sensitive enough (and, most importantly, not portable). Skin conduction, ECG and EEG aren't very sensitive either, but using fMRI is problematic also because, since it isn't portable and you can't use for months at a time, just minutes or hours, or in a natural environment, each person with BP would be in a different mental state. You would have to combine data of manic people with those of depressed people (and euthymic people, showing no symptoms at the time). Not surprisingly, the data would be roughly the same as that of "normal" people.

Edit:
Longitudinal MRI studies might work, though. But it would still be about effects, not the, probably manifold, root causes. Just to diagnose.

[Sunflower123]

I would be tested because I question my diagnosis. I think I need to be treated for MDD.

[halus1]

I have spent the last 5 or so years wondering about it - but not now. I don't think I need a test - it's very obvious to me with the way I often feel, particularly when I stop my medication.

I don't want to stop the meds anymore - I was off them not long ago when I came onto this forum and I felt terrible. I would rather that doesn't happen again if I can help it.

[Victoria'smom]

I'd take the test in a heart beat. If it was negitive I would urge my MH team to look at other dx. Like Sz and BPD.

[Unrigged64072835]

I don't know. I've been misdiagnosed with MDD for a long time. Don't want to go back to that hell again. I'll stick to what I have now, since it seems to be working.

[bioChE]

I'm OK with the concept of. being bipolar. No test needed. I've lived with the diagnosis for 20 years, been diagnosed by no less than six doctors. I've resigned myself to meds for life. I'll deal with the side effects as best as possible, and continue to pursue the perfect cocktail.