Newly Diagnosed?

Hello All!

I am reaching out to this forum as a way to find support and educate myself on my mental illnesses. My family and friends are very supportive, but don't really "get it", and they can't offer me any advice, because they don't have the issues that I do.

A little background, have been dealing with severe anxiety for a couple years now. Well, a couple of years of being treated, prior to that I was not. Was being treated by my PCP, who just kept upping my dose of much. I was also in therapy for a year and a half with a great therapist, we focused mostly on anxiety and childhood/family issues. Well after increasing the doses over the course of a year, I started to realize different symptoms aside from anxiety. Rapid mood swings...

I have always had mood swings. Especially hyperactive ones. My sister has always suspected that I had bipolar disorder, but I never really wanted to go there. Yes, I suspected too, but didn't want something to be "wrong with me". So after having these intense rapid mood swings, I almost had a breakdown. I had an appointment scheduled with a psychiatrist (who I can't get in to see for 6 MONTHS!) and went into my local health and human services outpatient mental health unit.

Did an intake with a psychotherapist who basically said, yes you are bipolar. I saw a Psych NP the next week who said, "I am not officially diagnosing you with bipolar because you do not have psychotic symptoms, but I am going to treat you like you are bipolar". Umm.... OK. So I finally felt validated when I realized yes, I am bipolar. There is a reason for the way I am, and the things that happen to me. But her saying that really got to me. She also told me I should be married to my S.O. and am wasting my
fertile years, WTF. I am hoping to get into the new Psych earlier, the therapist I am now seeing is associated with them and is trying to get my in earlier. Especially because the health and human services isn't covered by insurance and is self-pay....

So here I am, a week after starting Lamictal, weaning off my Citalopram (which made me worse, but hey maybe it gave me the kick in the butt to finally address this). Some side effects, but not bad anymore. Have noticed that I just feel a little more "dim" so to say. Mellowed out. Is it crazy to say that I want my hypomania back? I was so productive LOL. I was overactive the last couple of days, but now I'm a little dull feeling. I'm a full time graduate student and work part-time right now, so that push helps.

So, that is my story for now. I hope I can learn, get advice and find support from this forum.

Advice appreciated on the following topics
1. Finding a good psychiatrist relationship
2. Working while bipolar (I am a RN)
3. Medication management, what has worked best for you?
4. I used to self medicate a lot with alcohol, and then just social drinking. My circle of friends (late 20's) tend to drink during get-together's. I can't drink on the Lamictal I was told. Having a somewhat difficult time with this, as I enjoy beer and trying different IPA's. Also when I am drinking NA beer, I don't want to have to explain to people why.

Thanks All!

Welcome to pc! I’m not sure I can address your topics but I wanted you to feel welcomed. Right now I am on fmla leave from work (I am a teacher). This has unfortunately happened to me every year that I’ve been a teacher except last year. I am coming to terms with the fact that I probably won’t be able to continue teaching. It’s too stressful and it’s not something I can handle when depressed and/or mixed (no problem in mania though). I imagine as an RN you deal with a lot of stress. But if you’ve been able to work so far, you shouldn’t let your diagnosis change your outlook on working.

It is hard to find the right combo of meds. For some it takes years. Sometimes they work for awhile and then quit working. Every med will work differently for every person.

I can’t concentrate any more to write Anymore but again welcome to PC!

Hi Marley, I'm an RN too. I had a very difficult time holding onto jobs when I was unstable and I finally burned out four years ago. I'm on disability so I can't very well advise you on working while bipolar, except this: NEVER tell your boss or co-workers that you have BP. Nothing good comes from it. I was burned twice---lost jobs because my loose lips sank my ship. The Americans with Disabilities Act did not protect me at all...employers will just find a way around it and get rid of a person for some other trumped-up reason.

I wish you luck in your endeavors. Be careful, but enjoy your work. Being a nurse is an awesome responsibility.

I am not sure why the psych NP didn't diagnose you as type II instead of not all because of the lack of psychosis. I am type II. I am taking lamictal and still get small spikes of "happy puppy" hypomania every now and then, but between the lamictal and wellbutrin I am not feeling slightly depressed as my "center" any more. So, it's early to say you miss occasional hypomania. I am not sure if it is the same for you, but others close to me don't enjoy my hypomania as much as I do. I want to have long deep conversations and I get arrogant. Anyway, welcome!

Welcome to the forums, MarleyRN10!

I'm so sorry you had that WTF moment! WTF indeed! Very unprofessional (not to mention sexist and patronizing...) and absolutely IRRELEVANT to why you were there(!) Yikes.

That out of the way, I think #1 (Pdoc relationship) and #3 (med mgmt) are ideally kind of tied together. Personally, I find it useful to have a Pdoc that will work in partnership whenever possible (as opposed to simply dictating from on high). This assumes a responsibility for self-education, but being an RN, I bet that's right up your alley. Working from a premise of what is the least that gets the job done and when adjustments/additions are needed, doing just one at a time so as to know what is affecting what. This may not always be possible, but it's certainly what I'd aim for.

I might avoid that NP in the future if I were you.

It's really weird that she didn't want to diagnose BP because you don't have psychotic symptoms.

Most people with bipolar don't have psychotic symptoms.

Hi and welcome.
I was a health professional at the time of diagnosis. In my case I haven't been able to work since the day I was diagnosed. My psychiatrist said "I can't in good conscience let you near your work. In the state you're in, you will lose your professional reputation etc".
I DID speak to my HR etc. They were great. They kept my position open for 6mths and when I was still too ill to return to work they made sure I got salary continuance through insurance. I will have this payment until 65yrs. So my experience with how work dealt with me was good.

Most people will understand if you tell them you are on a med which interacts with alcohol, or you could tell them you have a sensitivity to it perhaps? The other questions I can’t answer as I have the same ones. I’m sorry you have this illness and I hope you find what you need to cope and thrive. (((Hugs)))

Welcome to the forums! Everyone here is really supportive and helpful.

It is an awesome responsibility! I love being a nurse.

I would love to avoid the NP, but it's the only prescriber I can actually get into in my area.... I'm hoping for a cancellation so I can set up care with an MD through my health system.

Thank you all for the advice and kind words. I'm glad to be here!

Welcome to the forum. Lots of great support here! On to your questions:

Advice appreciated on the following topics
1. Finding a good psychiatrist relationship
-this can be difficult. Finding someone that understands you will require some work.
I'd start out with a site like HealthGrades.com to get other patient feedback, while
also looking at your insurance website to find providers in network.

2. Working while bipolar (I am a RN)
-I agree with others. Do not disclose you are BP. There is a stigma attached to the
diagnosis. If someone needs to know, tell them you are depressed.

3. Medication management, what has worked best for you?
-this is a topic to work with your Pdoc on. All of us respond differently to meds, and so
will you. MAKE SURE you disclose everything you are feeling to the Pdoc.
I was having BP issues, but neglected to disclose my anxiety. I got to level on

Trileptal and had a blowout session of anxiety. My Bipolar wasn't there to mask
the anxiety. So, please be aware of that.

4. I used to self medicate a lot with alcohol, and then just social drinking.
-alcohol can mask Bipolar, but only for so long. Eventually, it will rear its head.