[leomama]

Anybody diagnosed with mixed bipolar?

Huh? I wasn't aware of such thing. I've only familiarized myself with two types.

[BeyondtheRainbow]

I am. So are lots of others.

(FOr 2ISAB mixed is having symptoms of depression and mania together. It's pretty much hell on earth).

[leomama]

Originally Posted by BeyondtheRainbow

I am. So are lots of others.


(FOr 2ISAB mixed is having symptoms of depression and mania together. It's pretty much hell on earth).

My psychiatrist says it’s a controversial dx. It’s like complex ptsd in that regard. When were you dx and what do you do to treat it?

[BeyondtheRainbow]

16 years ago. I'm on a lot of meds. I also see a therapist weekly and increase to twice a week if I start to lose control.

I think it is a difficult thing right now because the new DSM changed it. It used to be that if you were mixed that meant you were BPI. However lots of doctors used it with BPII also.

Now they've changed it and checking what I thought I knew what I said originally isn't exactly right. It used to be you had to meet full criteria for both depression and mania together. Now you just have to have some traits of both.

I've never heard it was controversial outside of the disagreements about relationship to BPI or II.

[Pookyl]

I was diagnosed with Bipolar 1 3yrs ago. Almost all my episodes are mixed.
I take Epilim, Lithium, Seroquel XR & Seroquel IR.
My psychiatrist doesn’t call it a controversial diagnosis but she does say it’s difficult to treat.

[leomama]

Originally Posted by BeyondtheRainbow

16 years ago. I'm on a lot of meds. I also see a therapist weekly and increase to twice a week if I start to lose control.

I think it is a difficult thing right now because the new DSM changed it. It used to be that if you were mixed that meant you were BPI. However lots of doctors used it with BPII also.

Now they've changed it and checking what I thought I knew what I said originally isn't exactly right. It used to be you had to meet full criteria for both depression and mania together. Now you just have to have some traits of both.

I've never heard it was controversial outside of the disagreements about relationship to BPI or II.

I was told its not on the books.

[BeyondtheRainbow]

No, it's still there as a feature (descriptive addition to diagnosis. My icd10 diagnosis code from the other day is F31.61, bipolar 1 disorder, mixed, mild. Usually I go up and down on the mild part but have been doing pretty well at holding fairly steady since my AP was increased quite a bi with some psychosis this summer.

[BeyondtheRainbow]

This is BPII and all the features for its' diagnostic code:
2018 ICD-10-CM Diagnosis Code F31.81: Bipolar II disorder

This is BPI:
2018 ICD-10-CM Diagnosis Code F31.60: Bipolar disorder, current episode mixed, unspecified

[leomama]

Originally Posted by BeyondtheRainbow

No, it's still there as a feature (descriptive addition to diagnosis. My icd10 diagnosis code from the other day is F31.61, bipolar 1 disorder, mixed, mild. Usually I go up and down on the mild part but have been doing pretty well at holding fairly steady since my AP was increased quite a bi with some psychosis this summer.

I got a f31.62 for the first time ever in my whole entire life and after gotten dx with everything from adolescent identity disorder as a teen through dysthymia, complex ptsd, ptsd, personal disorder not otherwise specified, emotional shock, generalized anxiety disorder, and now decades later mixed bipolar? I don't think so. I'm taking my psychiatrist to task for this and talking to two of my therapists about it. I'm furious with him. I don't even want to spend $125 to talk with him a half hour to deal with this, but I'm going to calm down, call my insurance, and go from there. To think, the first time I use private insurance I get diagnosed with bipolar. I'm so angry.

[BeyondtheRainbow]

You were diagnosed with mixed bipolar the first time you met the doctor? That seems kind of extreme to me. Some pdocs won't even diagnose bipolar at all until they've had a few sessions with patient and mixed episodes are a kind of specific form of it. Maybe he had a reason but if he said mixed bipolar and then suggested no meds? (Did I understand that correctly?), that's weird. Usually you get stabilized on meds before trying to go medfree.

Do you think you have bipolar?

[leomama]

Originally Posted by BeyondtheRainbow

You were diagnosed with mixed bipolar the first time you met the doctor? That seems kind of extreme to me. Some pdocs won't even diagnose bipolar at all until they've had a few sessions with patient and mixed episodes are a kind of specific form of it. Maybe he had a reason but if he said mixed bipolar and then suggested no meds? (Did I understand that correctly?), that's weird. Usually you get stabilized on meds before trying to go medfree.

Do you think you have bipolar?

Oh no I worked with him about 10 years ago. He diagnosed and treated my complex ptsd and at the time he mentioned bipolar but I never saw any diagnostic codes from him. I went back to him because I'm ready to go off lamictal and since he's the one who prescribed it I wanted him to be the one to supervise my going off it even though he's an out of network doctor for me. No I don't think I have bipolar at all, and I'm going to be talking to my therapist on Saturday about this. I'm very upset about this. No he said I could go off my medication if I wanted to but I was going to have to replace it with someone else. I have no problem with my mood disorder diagnosis, dysthymia, but bipolar? That's never been suggested by any of my mental health care providers at any time in my life and I am now 42 years old. Its possible he diagnosed me with that back in 2007, I'm going to ask him what ICD code he used back then.

He initially prescribed lamictal and seroquel (as a sleep aid). I've been on lamictal for over a decade.

[BeyondtheRainbow]

That is definitely odd. I hope your therapist can help you sort it out. Do you have another appointment scheduled with the pdoc?

[leomama]

Originally Posted by BeyondtheRainbow

That is definitely odd. I hope your therapist can help you sort it out. Do you have another appointment scheduled with the pdoc?

As soon as I found out how to make it count towards my deductible. It’s possible he may have given me an f31.62 or however it’s written at the outset and I didn’t know it. At the time he said he was treating me for complex ptsd, and was disabled due to ptsd for a decade. That’s very real. I accept Id had dysthymia since I was a teen, but bipolar? Um, where?

[BeyondtheRainbow]

If he had diagnosed you with bipolar before disability you'd surely have seen it on some form. The coding did change a year ago. The old code for BP was 296._____

Maybe there is something in the new coding system that changes the dysthymia to BP but I still think the mixed thing would be weird as a surprise diagnosis. There is definitely a lot of reasons to not want a BP diagnosis and I think if you are being diagnosed that (or being diagnose with something your pdoc doesn't believe still exists? That is so confusing) you deserve a chance to ask questions and become comfortable with what is being said.

[leomama]

Originally Posted by BeyondtheRainbow

If he had diagnosed you with bipolar before disability you'd surely have seen it on some form. The coding did change a year ago. The old code for BP was 296._____


Maybe there is something in the new coding system that changes the dysthymia to BP but I still think the mixed thing would be weird as a surprise diagnosis. There is definitely a lot of reasons to not want a BP diagnosis and I think if you are being diagnosed that (or being diagnose with something your pdoc doesn't believe still exists? That is so confusing) you deserve a chance to ask questions and become comfortable with what is being said.

The dysthymia was by a therapist before him. The ptsd was by a social security psychiatrist. His diagnosis is unrelated to either. My icd code is 31.62, current episode, mixed, moderate . I went to see him because I want to go off lamictal and I told him I hadn’t blood work done in over a year.

It’s possible he diagnosed me with this the last time I saw him in 2009. I’m going to ask him, and then I’m going to ask him to explain himself.

I don’t want the diagnosis because I don’t think it fits. I’ve NEVER experienced mania.

[piano97]

I've had a mixed episode before and it is utter hell. No one should ever have to experience something like that.

I don't know if 'mixed' is technically a diagnosis but a current specifier, such as Bipolar 1, most recent or current episode mixed (or manic or depressed).

[leomama]

Well if I do have it I suppose I have a reason to feel compassion for myself, since two of you have said it’s utter hell. I mean I always knew my life was difficult.