[theForce]

I'm familiar with cases where the patient, after a brief visit with a therapist, is merely prescribed a mood stabilizer. This treatment is followed up with regular visits, observation, and results are borne from a trial and error process.

In my opinion, that foregoing tactic comprises the least cost and effort when it comes to diagnosis and treatment. However, I am posting here because I am almost certain (but unfamiliar with) cases where patients enjoy varying degrees of thoroughness in the area of psychiatry.

All I can imagine right now, based on brief skimming online, is that in psychiatry diagnosis and treatment is elaborate and the trends in precision are evolving.

If you are an expert in areas relating to psychiatry please suggest approaches I should take for the diagnosis and treatment of bipolar disorder.

If you otherwise have received psychiatric treatment that was more comprehensive then please also offer suggestions.

Is there some reason why this office (successfully) faltered my attempts to get help with my disorder (bipolar)? I made an email to a neuro-psychiatric research facility in North Carolina. I asked if there were such a thing as use of medical imaging (such as PET) or EEG (electroencephalography) to gain precision in diagnosis of my condition. I was not given an answer. I feel like they must not use that approach to treat and diagnose their patients. I also feel like they don't deal in cases such as bipolar disorder because it is not suitable for garnering research funding.

Thanks,

theForce

[bioChE]

If you're looking for a physical/biological test for bipolar, you're going to be searching in vain. Psychiatry is focused on defining symptoms (psych/social/behavioral) and then trying to treat those symptoms. A lot of it is trial and error.

If you come up with another way to diagnose and treat the disorder, you'll be a very rich person.

[Skeezyks]

Hello theForce: I see this is your first post here on PC. So... to PsychCentral… from the Skeezyks! May the time you spend here be of benefit.

PsychCentral is a great place to get information as well as support for mental health issues. The more you post, & reply to other members’ posts, the more a part of the community you will become. Plus there are social groups you can join & chat rooms where you’ll be able to connect with other PC members in real time (once your first 5 posts have been reviewed & approved.) Lots of great stuff! So please keep posting!

[theForce]

Originally Posted by bioChE

If you're looking for a physical/biological test for bipolar, you're going to be searching in vain. Psychiatry is focused on defining symptoms (psych/social/behavioral) and then trying to treat those symptoms. A lot of it is trial and error.

If you come up with another way to diagnose and treat the disorder, you'll be a very rich person.

You are deflecting my question. Did you try googling trends in diagnosis and treatment psychiatry? I did and the first hits show this is an active topic in the field of psychiatry. To think it is as simple as using a DSM and trying things out then your vantage point isn't from a cost and benefits horizon. So it is you that isn't a rich person because rich people enjoy a broad array of advocacy before receiving treatment. I'm not rich but I know how not to think like a poor person. There's a word for that thinking and it's high-school. In high-school we think that "psychiatry is mostly trial and error" and "anyway". But you will have trouble telling behavioral health/medical experts your opinion -- unless their goal is to get you out the door. Now please let me ask my question to the people here who know the answer because they either work in research or they are anonymous patients who know about treatments -- your treatment is obviously the bare essentials and I hope you don't fall into that trap because you won't like where it ends.

[theForce]

Originally Posted by Skeezyks

Hello theForce: I see this is your first post here on PC. So... to PsychCentral… from the Skeezyks! May the time you spend here be of benefit.

PsychCentral is a great place to get information as well as support for mental health issues. The more you post, & reply to other members’ posts, the more a part of the community you will become. Plus there are social groups you can join & chat rooms where you’ll be able to connect with other PC members in real time (once your first 5 posts have been reviewed & approved.) Lots of great stuff! So please keep posting!

Ok I will keep this in mind.

[Fuzzybear]

Welcome

[Sunflower123]

Hello!!! Welcome to PC.

[Teddy Bear]

Usually all they do with me is talk about life like my job to see how I respond. Then just give me my meds never any neet testing like that.

[bioChE]

Originally Posted by theForce

You are deflecting my question. Did you try googling trends in diagnosis and treatment psychiatry? I did and the first hits show this is an active topic in the field of psychiatry. To think it is as simple as using a DSM and trying things out then your vantage point isn't from a cost and benefits horizon. So it is you that isn't a rich person because rich people enjoy a broad array of advocacy before receiving treatment. I'm not rich but I know how not to think like a poor person. There's a word for that thinking and it's high-school. In high-school we think that "psychiatry is mostly trial and error" and "anyway". But you will have trouble telling behavioral health/medical experts your opinion -- unless their goal is to get you out the door. Now please let me ask my question to the people here who know the answer because they either work in research or they are anonymous patients who know about treatments -- your treatment is obviously the bare essentials and I hope you don't fall into that trap because you won't like where it ends.

I'm a scientist and engineer and work in pharmaceutical research. You have absolutely no clue of my financial state. I'm well aware of how to use Google. I've also been dealing with bipolar and psychiatry/psychology for well over twenty years. I've dealt with over 15 psychiatrists in various settings both outpatient and inpatient, including at some of the top research medical centers in the world.

Before trying to call someone out, you might try to get a bit of background and a clue yourself.

[*Laurie*]

There is no test at this time that can make an absolute diagnosis of bipolar disorder.

Three posts in and already hostile?

[wiretwister]

Originally Posted by neodk

Three posts in and already hostile?

Remember a chip on the shoulder only gets you a sore shoulder ….. Did seem a little over the top to me also ...

[Guiness187055]

It's all about the symptoms plain and simple. That's how we are treated everything else is just an educated guess. What does it matter really if our symptoms are under control then all is well.. just my two cents.

[theForce]

Originally Posted by bioChE

I'm a scientist and engineer and work in pharmaceutical research. You have absolutely no clue of my financial state. I'm well aware of how to use Google. I've also been dealing with bipolar and psychiatry/psychology for well over twenty years. I've dealt with over 15 psychiatrists in various settings both outpatient and inpatient, including at some of the top research medical centers in the world.

Before trying to call someone out, you might try to get a bit of background and a clue yourself.

There really is more to diagnosis and treatment than treating symtoms and trial and error. If you were more interested in trends in diagnosis and treatment in the field of psychiatry then you would know this. You spoke of your credentials and background. But there are lots of people with advanced degrees in the sciences who aren't interested in much of the field they studied during years in college and beyond. I know you aren't working with colleagues to treat and diagnose along contemporary trends. I know because you want to stick with the mainstream methods. I believe that in a research setting, patients are likely to have different options. Different options then in the setting where the doctor is not interested in research. All I hope for is to hear from doctors, patients, and other behavioral health who know about trends in diagnosis and treatment of mental disorders -- not just sticking with what many people could guess. We are talking about a specialized field of science. Not all those who practice do so in the same way. It depends on what areas they have interests in.

theForce

I thought this was a happy place?

[theForce]

Originally Posted by *Laurie*

There is no test at this time that can make an absolute diagnosis of bipolar disorder.

The issue is trends in diagnosis and treatment. Also, what facilities to deal with and how to deal with a doctor to obtain currently available options when you are being diagnosed. I can accept that in the end no matter how "focused" one is on psychiatric conditions that they (currently) can only be diagnosed/treated with trial and error evaluation of symptoms. But that doesn't mean that there are not new developments. I want to deal with people who are current and know about these developments. Many doctors and patients fall into a bare minimum routine when it comes to answering the question "what can be done about my mental disorder?". But not everyone in that camp is stuck in the past. Some patients and therapists know about the trends in psychiatry and consider that *before* veering towards some mood stabilizer. Anyway, I can't go around calling behavioral health facilities and asking who is interested in research and who isn't. I need to know which facilities to deal with and how to ask a professional for the services I need. This way they will help me.

theForce

[rwwff]

Originally Posted by theForce

But that doesn't mean that there are not new developments. I want to deal with people who are current and know about these developments.

Here's the deal though; even if they *are* current on where the research is, or even participating in it; they are very unlikely to take a patient off the street and run them up into the research study. It presents very large liability issues with little likely gain in outcome.

In addition, when they order expensive testing that the insurance companies know provide very little benefit, those doctors and facilities get dinged on their compensation, and can eventually get booted off of a network.

Now, if you can pay cash, let me suggest something. Concierge medicine. These are MD/DO's who do not take ANY insurance of any sort, you generally write a check up front as a retainer type deal. They can order imaging, and you will have to pay cash for it too, and THAT is extremely expensive. But doable. You can get those tests, and have them read. So there is a path to what I think you are looking for, but I do not think you will get what you want in the end.

And the reason is simple...

"bipolar" has no biologically testable definition. Period.

For now, we have a list of symptoms, and some sets of interventions that mitigate those symptoms. And that is all.

I too think you are reaching too high. It seems you are looking for a concrete answer as to why you are bipolar rather than concentrating on how to manage and deal with it in your daily life.

I notice you refer to a therapist. In my opinion there are stark reasons differing between seeing a psychiatrist and seeing a therapist. I believe one should start with seeing the first; who can make that diagnosis and help manage the disorder with medication (which I believe is necessary). The therapist meanwhile can arm you with coping mechanisms and manners in which to manage the difficulties and resulting behaviors.

I understand the need to know; however, consider this, finding a reason in no way is going to change the treatment.

[Naynay99]

Hey. While I read a lot, I am not that knowledgeable in this area but it sounds like the OP is looking for somewhere to get brain imaging tests (fMRI, PET, etc) that they think will help in dx. While research studies use these imaging tools, from what I have read they do not seem to be all that useful in diagnostics or actually differentiating among similar mental disorders (depression, bp, schiz).
I would also imagine that they are very expensive, and even if one were willing to pay out of pocket you would probably still need a prescription for such tests from a doctor. I would think any major imaging lab or research hospital would probably perform such tests?

That said, if this is important to you, why not look into current clinical trials going on that would use these scans as part of their research? Check out https://clinicaltrials.gov
Best of luck.

[Wild Coyote]

Ae you looking for something possibly like this, where they use genetic testing, biomarkers, MRI, PET scans, etc?

The Menninger Clinic

Comprehensive Psychiatric Assessment Service - What to Expect


WC

[Nammu]

You might want to check out the mayo clinic they are conducting research into bipolar but you must be diagnosed bipolar to participate....so there's a dilemma for you.

[theForce]

Originally Posted by rwwff

Here's the deal though; even if they *are* current on where the research is, or even participating in it; they are very unlikely to take a patient off the street and run them up into the research study. It presents very large liability issues with little likely gain in outcome.

In addition, when they order expensive testing that the insurance companies know provide very little benefit, those doctors and facilities get dinged on their compensation, and can eventually get booted off of a network.

Now, if you can pay cash, let me suggest something. Concierge medicine. These are MD/DO's who do not take ANY insurance of any sort, you generally write a check up front as a retainer type deal. They can order imaging, and you will have to pay cash for it too, and THAT is extremely expensive. But doable. You can get those tests, and have them read. So there is a path to what I think you are looking for, but I do not think you will get what you want in the end.

And the reason is simple...

"bipolar" has no biologically testable definition. Period.

For now, we have a list of symptoms, and some sets of interventions that mitigate those symptoms. And that is all.

There was a very poor woman I knew who suffered from seizures and received brain surgery that employed robotics. That sounds expensive but it was provided to her at no cost. She was delighted to tell me her seizures are gone. And I can tell she isn't brain damaged because we have had detailed conversations with each other and her limited mobility problems are not from brain damage.

I realize that parts of the brain that cause seizures are not the same as those causing emotional disorders. For emotional disorders I haven't heard of treatments involving robotics and brain surgery. But my point is that given an area of medicine, like psychiatry, doesn't mean you have to have lots of money. But if you do have lots of money then you will be charged because you can afford it. Finances aside, I believe psychiatrists discuss amongst themselves cutting edge and trending advances in their field but not with patients. However, I have yet to find someone on this thread who is willing to take the challenge of asking their doctors about trends in diagnosis and treatment of bipolar disorder. The answer is partly true that they don't want to talk about that with you. But if you keep asking you will learn that there is more to just taking meds and moving along. That is the main reason I have been replying here because it helps me deal with the answers that I will invariably get. Alot of doctors aren't interested in novel ideas they just want to deal with the here and now.

[theForce]

Originally Posted by Naynay99

Hey. While I read a lot, I am not that knowledgeable in this area but it sounds like the OP is looking for somewhere to get brain imaging tests (fMRI, PET, etc) that they think will help in dx. While research studies use these imaging tools, from what I have read they do not seem to be all that useful in diagnostics or actually differentiating among similar mental disorders (depression, bp, schiz).
I would also imagine that they are very expensive, and even if one were willing to pay out of pocket you would probably still need a prescription for such tests from a doctor. I would think any major imaging lab or research hospital would probably perform such tests?

Best of luck.

Yes. My mother answered a text I sent her asking about medical imaging and diagnosis in lieu of the Disgnostics Statistical Manual/psych drug trials. She reads a lot about the area of using those tools as well and she would agree with you. She told me that medical imaging is better used as research tool. I remembered the research I had read about using medical imaging and post-traumatic stress disorder for former war veterans. It was more about evidence to substantiate findings than it was to actually treat the patient for things like an unchecked stress response (which is part of PTSD).

But I am wondering what methods are being used to treat and diagnosis mental health problems -- we all know about the medication trials and the quick glance at the DSM. And yes the topics diagnosis and treatment are vast and employ very expensive methods that may not even be (currently) available. Doctors may offer that no matter what 'trends' are going on; the diagnosis and treatment of mental disorders depend (mostly) on only a hand full of tools that came about in the 20th century. But who knows? Guided by the facts that, at least to them, diagnosis and treatment is and has been evolving. You have to make sure the doctor you are dealing with is on top of these trends because you are paying for their service. Why not get the best treatment you can afford. Shopping around isn't easy. It takes a lot of digging to find what is out there and weather you can afford it or not.

[theForce]

Originally Posted by Wild Coyote

Ae you looking for something possibly like this, where they use genetic testing, biomarkers, MRI, PET scans, etc?

The Menninger Clinic
()


WC

This looks like what I need, although I need to take the time to look into them. I previously mentioned that I tried emailing NC Neuropsychiatry.

Not surprisingly they didn't reply to my email about medical imaging and electroencephalography (eeg) in lieu of the DSM and prescription trials. I really don't know what to do to approach and deal with these sorts of facilities like the one you mentioned and the one I gave.

My guess is that you have to 'sign up' so to speak. Get into their treatment system and after when you have that first visit with a doctor then try asking them your questions about advances in diagnosis and treatment.

But there is another problem. What if they place you are going to is geared toward profiting in some way from a certain group of people. For example, I don't know this but I think the facility I gave from North Carolina depends on children with asperger's to garner research funds and I don't think they enjoy business from people with bipolar disorder. Just a hunch...if it is true then what?

My girlfriend got the que tip swab and the genetics testing. You can use saliva to obtain dna from a patient. Then using a database that dna can be used to match a persons chromosomes to those that relate to problems as well as medicines. My girlfriend got this treatment paid for with government well fare (medicare). I think that path would be helpful. I know for a fact that my medication can't be the one and only for me. But is the saliva swab the only latest advance in treatment?

[Wonderfalls]

If there were any new and effective methods of bipolar detection then the information would be printed in medical journals, not kept secret among certain cabals of psychiatrists as you seem to think.