[Beana77]

Ever since I was diagnosed bipolar 7 years ago, almost every therapist I've had has doubted my diagnosis. I recently read in the book "The Other Depression" by Robert Grieco (great book) that this is pretty common because therapists are behind on the science.

My current therapist keeps asking how often I get manic and how severe it is. Since I'm type II, I don't get fully manic, I just have episodes of hypomania. Technically, you only need one manic or hypomanic episode in your life to qualify for a BD diagnosis.

I just find it a bit confusing to have a therapist doubt my diagnosis and treatment. I know she thinks I'm overmedicated and she's tried to talk to my pdoc but he won't call her back. He probably deals with meddling therapists a lot and doesn't want to deal with it.

Overall, I like my therapist, but I find it a bit irritating that she's so focused on my meds when that's outside her area of expertise.

Whoa. Lots of red flags here.

First of all, if your therapist does not have a license to prescribe medication, she should NOT be giving you medical advice. That is not her area of expertise and she should stay out of it. I also think it's against her license to do that (if she is indeed not allowed to prescribe medication). She could lose her job because of her medical advice, and she should.

Second of all, I would put aside the diagnosis doubting for a second. If you're doing well on your current medication cocktail and it's helping, then don't worry about people's doubts. But I do want to know: did anyone explain why they doubt your diagnosis?

[Carmina]

A therapist has a duty of care and that includes raising concerns about a client being possibly over medicated or showing side effects. That is not 'prescribing' anything, it's just good practice. They can also have just as much knowledge, and often more, about psychological conditions as a psychiatrist, particularly since psychiatry is so much dominated by a medical model. I would be more concerned if a therapist did not question things like that and just blindly went along with working with a client when they had concerns about their treatment or diagnosis.

[Wild Coyote]

Thanks for mentioning the book. I'll look it up.

Have you offered to let your therapist borrow the book?
From what you've written, it sounds like she is misunderstanding BP II?

As for her feeling you are overly medicated, she'd taking her cues from you. Do you feel overly medicated? If so, tell your pdoc .


WC

[Victoria'smom]

Every therapist and Pdoc has me under different diagnosis from mood disorder NOS to personality NOS even Intermittent explosive disorder. Therapists regularly think I'm under medicated even when I can't/won't deal with the side effects of heavier doses. They all agree that I have psychotic symptoms but disagree with the cause. I've stuck with SzA. Are you happy with your med mix? If you think your over medicated then by all means talk to him/her.

If your therapist says she thinks you're over medicated just tell her you'll talk to your dr and move on.

[zbmom]

Sometimes bipolar is overdiagnosed. It's fine for your therapist to talk to your pdoc so they can coordinate care. Bipolar II can be hard to tell apart from major depressive order if your therapist never sees you during a hypomanic episode. I've questioned my diagnosis before but it really doesn't matter. Your therapist needs to support you and the diagnosis is only useful for treatment. Just let them know you're comfortable with your pdoc and what your goals are for therapy. They should work with you. It really is more of a medical diagnosis and though a therapist can diagnose bipolar it's better for a psychiatrist to confirm it.

[noneedtoknow]

Originally Posted by zbmom

Sometimes bipolar is overdiagnosed. It's fine for your therapist to talk to your pdoc so they can coordinate care. Bipolar II can be hard to tell apart from major depressive order if your therapist never sees you during a hypomanic episode. I've questioned my diagnosis before but it really doesn't matter. Your therapist needs to support you and the diagnosis is only useful for treatment. Just let them know you're comfortable with your pdoc and what your goals are for therapy. They should work with you. It really is more of a medical diagnosis and though a therapist can diagnose bipolar it's better for a psychiatrist to confirm it.

Greetings,

I'm just confirming, a therapist can diagnose?

[RedDawn]

Originally Posted by noneedtoknow

Greetings,

I'm just confirming, a therapist can diagnose?

All kinds of therapists, social workers, psychologists, etc. are trained to diagnose.

Depending on what kind of insurance you have (in what country, etc.) you may need a psychiatrist to confirm that diagnoses to be compensated for treatment.

Only medical doctors can prescribe.

[Carmina]

These days diagnosis is often an iterative process and can involve the contributions of several members of the team, including of course the patient themselves. So many conditions can be confused or merge into, or co-exist, with each other. It's not an exact science.

[Beana77]

I do feel overmedicated actually. We have discussed it in therapy as a source of problems at work (feeling foggy, making mistakes), but I'm getting irritated with how hard she is pushing about it. My pdoc won't call her back. She's now encouraging me to find a new pdoc but I'm happy with the one I have. He is open to my suggestions for reducing my meds, but I haven't been successful with doing it because I keep going through periods of instability.

My therapist has never seen me hypomanic and I've been going to her for almost a year. I don't think she understands that you only need one hypomanic episode to warrant a BP diagnosis. I really like her otherwise, but it just messes with my head to have my diagnosis questioned.

[Wild Coyote]

Can you tell your therapist you'd like her to "back off" from this a bit?

You sound like you are fine with your pdoc and with your diagnosis.


WC

[tecomsin]

It sounds like there are three separate issues that you could raise directly with your therapist.
1. feeling overmedicated and all the ins and outs of that. Since both pdoc and tdoc and you seem to agree then maybe you can get the help you need to slowly taper off one or more.
2. her suggestion you switch psychiatrists. It might be helpful to just have a direct conversation with her about that. Maybe also with the pdoc.
3. her questioning your diagnosis. Maybe that is also worth discussing with her... telling her it messes with your head could be a start.

[Nammu]

I have found Ts to be more observant and right concerning diagnosises since they see you much more often and observe you for a much longer period of time. So what if she is right? Pdoc diagnosises are based on the patient self observation. What is so upsetting to not have a BP diagnosis you could have major depression all that means is that you are further toward one end of the spectrum instead of in the middle. It doesn't mean you don't have a mi or that you were wrong to take meds.

[Beana77]

I met with my therapist yesterday and I wasn't feeling very confrontational. She did ask to go over my meds again but didn't say anything about my diagnosis or psychiatrist.

I agree that my therapist probably knows me better, but my pdoc actually spends 30 minutes with me which is a pretty long time for a psychiatrist.

Yesterday I had a panic attack so even with all these meds I'm still symptomatic. I don't know what the answer is.

[fishin fool]

So many symptoms of MI overlap that I can see how people get a different diagnosis
from different docs. If your symptoms are being treated I wouldn't worry to much about
your diagnosis.

[ducky2030]

I have been in the same situation in the past...most people don't recognize there are different types of bipolar disorder rather than just plain ole BD I... and all the symptoms overlap with other disorders.

[glennk]

Great book, An Unquiet Mind. It is written by a psychiatrist that was diagnosed with Bipolar Disorder.