[wildflowerchild25]

So...had weird session with my program therapist today. Keep in mind that I don't really like her much. But today kind of compounded those feelings.

First, she asked me if I had ever had a manic episode, with a trace of doubt in her voice. This has been something I've been struggling with myself, as I don't think I have ever been full-blown manic, just hypomanic. I'm doubting my bp 1 diagnosis and thinking I have bp 2, but anyway that doesn't matter. So I said I've definitely been hypomanic, not sure about manic. She asked me how I knew I was hypomanic - I said I needed less sleep, was more energetic, racing thoughts, etcetera. She still looked unconvinced. Keep in mind this is the third time I have met with her and the last two times I was severely depressed/mixed.

so she asked me then how long my mood cycle would last for, and I responded that without medication they would last approximately two weeks. she seemed to light up and then suddenly switched subjects and asked me about my periods instead. I've never had regular periods and told her such. Then she went on a whole topic about how so many women are diagnosed with bp when really it's a hormonal thing. She said i need to track my period and my mood and see if they match up in any way.

I am so upset by this. It's taken me years to accept the bp diagnosis, and I think i've developed a lot of insight into my episodes, and i do all the right things to deal with them, and this woman is telling me I may not even have bipolar at all? I mean, it should make me happy but it really doesn't. I feel lost. To think I've spent all this time treating bipolar, hospital stays, meds, ECT...

Now i'm doubting everything. I KNOW there have been times where I am more energetic, euphoric, sped up, racing mind, etcetera. And another part of me is saying this CAN'T be true, I've been in depression/mixed episodes for longer than a month before, hence why I've had ECT.

But also....I was stable when my prolactin was high, making my periods disappear. I stop invega, prolactin levels out, period comes back, suddenly i am symptomatic again. Was it the meds...or the hormones?

I've heard of PMDD but I've never heard of PMDD or PMS causing hypomania. But maybe it can? Maybe this really is hormonal. Then what would treatment even be?

I'm just upset. I feel like she's invalidating everything I've been through at this point. Meeting me three times and telling me oh, it's probably hormones, you don't have bipolar. She's not even a doctor. I'm so lost now

TL;DR new therapist says my problem might be hormonal and not bipolar at all.

[Naynay99]

Ugh. I'm sorry you are feeling upset and frustrated by them questioning a dx you have worked hard to come to peace with. I would try not to over focus on the label- it is so subjective and there is so much overlap between disorders that I think our current way of diagnosing is shiit anyway. I think it is a very human thing to want a speciifc name to explain what is wrong with us, but the brain isn't like other organs where it is so clear.

If the treatments and strategies that you used in the past helped you that is all that matters. Except for insurance purposes the dx is just a code that is rather meaningless. It gives drs a guide on what meds to try but that's really all it is useful for. So try not to let that become the focus. Just keep focusing on being well. Take care. Hugs.

[~Christina]

My arm chair Pdoc hat on .... your Bipolar. Since you found Pc and learned more about you “ illness” everything has clicked” bipolar”

Sure hormones can fluctuate things but not to the degree you have posted on PC

I think the program Therapist is not helping matters having this hormonal shyt taking front and center stage.

I have read your Threads and in trouble I see you as having Bipolar.

My mania isn’t happy it’s full of self loathing anger and many years of cutting etc... it’s never fun nor pretty.

Mania never presents the same each thing me for me , there is usually a component added or missing, but in the end I’m manic.

(((((((( hugs ))))))

[Nammu]

There might be a hormonal part to the illness but that doesn't mean that there's no BP. For me things got very much better after menopause but I still struggle with BP

My first therapist said "not bipolar" after a few sessions. I was thinking, "lady, do you think you even know me after a few sessions?" She even had the audacity to say I've never experienced depression, and implied that I didn't know what depression was. Liar.

My current therapist said she's seen me manic a couple of times, and she's been seeing me for a year now. I didn't have a manic episode until about the 12th session with her (I see her weekly). She just needed time to assess me, as IMO she can't assess me after only a few sessions. That's b_llshit.

Btw, I keep going on/off meds, so I have episodes frequently (because I'm an idiot).

So based on my experience, I would say that your therapist should NOT be diagnosing you after 3 sessions. She's either inexperienced or doesn't know what she's doing. (Sorry, but I really think your therapist doesn't know what she's doing if she thinks it's ok to diagnose a mood disorder after only 3 sessions.) Mood disorders need time to show themselves.

[liveforsummer]

Thanks for the thread and all the responses. I find this most helpful to read as when I’m in my BP denial phase I always gravitate to thinking all I’ve gone through this year is hormones. The rational me is pretty sure it’s not hormones but they can certainly affect things as stated. I asked my pdoc and she’s pretty sure it’s BP2 and if left untreated I’d only wind up back in her office in a worse state. All I know right now is I think the Med she prescribed is helping regardless of diagnosis.

[wiretwister]

my former T , a psychologist said he normally can "size someone up in three sessions" ... I think they may be taught that way .. took him 6 to get a handle on me ... this was spread out over 3 months ... my " hypo or mania " .. what ever you want to call it is expressed by irratability and rage ... no happy times for me ... he actually reinforced my dx ... said he saw my changes over the months ...

thankfully my T and pdoc agree 100% ...

I would think if she thinks the hormones are an issue ... has she ever suggested you get tested ... if she is right god bless the relief ... if not then you know just how much stock to put into her opinions ... I mean if it gave you some relief go for it ... I doubt it will ... but keep an open mind ... after all the end result is to feel better .. however we get there ...

ps ... (your bp .. JMO)

[wildflowerchild25]

I think maybe hormones play a part In my moods but there’s just no way that all I’ve been through since 2013 is due solely to hormones. I feel as though my therapist is dismissing me and invalidating everything by suggesting that it’s a hormonal issue. It just doesn’t fit. Yes, I do get irritable when I have pms. But it’s different from a hypomanic irritability.

Ugh. Thankfully this woman is not my regular t, just my program t. And the doctor I saw today made no mention of the hormone issue. I’ll stick with the doctor’s opinion.

[tecomsin]

I think it takes a kind of arrogance to meet someone a few times and tell them that everything they have been told about their MI is wrong...

I also think there are some birth control pills that keep hormones stable, so that might be something to think about since you mentioned that you were more stable when not menstruating.

Another might be to chart your mental state vs your cycle for awhile (months) and see if there is a connection. FWIW I was more moody before menopause but the underlying disease pattern is still the same. The depression has a different flavour, so does the mania but the psychosis is the same.

[giddykitty]

I keep stumbling on these older topics, but this is still a current issue. I'm there with ya! But I'm inclined to believe maybe I have both bipolar and PMDD. The menstrual related mood swings have been easier to document, but finding and keeping a good gynecologist has been a pain. And I also hadn't done well, symptomatically, with birth control in the past, so I hesitate there. At any rate, I'm kinda in the same boat, struggling to find a treatment that fully works. I could go on, but my battery is about to die. :P

[pirilin]

Great!!. Neither am I.

[LadyShadow]

Oh don't let them tell you that crap wildflowerchild25. Seriously. You know yourself better than anyone else, and you know what your therapist and your pdoc have been telling you for years.

As far it being "just hormones" I am literally a walking example of hormones gone completely awry. I was born without a thyroid gland, and it severely screwed everything to do with my metabolism, period, EVERY DAMN THING. Sure, I take synthroid, but there is just so much a medication can do in place of an organ.

I suffer from all those hormonal ailments you describe, irratibility being on the top of that list, and as for my period, I haven't seen it since early 2017, and that's a whole other issue in itself.

So, no, stick to your guns on your bipolar diagnosis. Don't let that woman fool you. Just take care of you, take your meds and be as compliant as you can.

[tsrc78]

Ugh. I know this is an old post, and I hope that you no longer have these doubts wildflowerchild. But just in case, and for anyone else dealing with this, I will offer my story.

I was actually misdiagnosed with PMDD before my bipolar diagnosis. It was assumed that just because I had severe mood swings before my cycles, it must be PMDD. Problem is PMDD is NOT just treated with hormones. They are also usually treated with....(dramatic pause).....antidepressants. Some women take antidepressants everyday, others only take them about the second half of their cycle, usually 1 - 2 weeks before their periods.

At that time my primary doc was treating me for that, as she had been for the many years I was diagnosed with depression. She referred me to a gynecologist, I think. Don’t remember if the gyn gave me anything, but it definitely wasn’t birth control. Even though we were on the path to adoption, we never stopped trying to conceive. So what does my primary doc do? Up my antidepressants, giving me an increased dose in the second half of my cycle. I was tracking my cycles anyhow, so this should have worked. Wrong. I got WORSE. It was actually because my PMDD treatment failed, as long as many years of antidepressant failures, that prompted my primary doc to finally refer me to a real psychiatric provider, and a therapist.

After hearing my symptoms, my pdoc and therapist worked together to give me a mood chart, to track my symptoms everyday, from levels of high to low. They said I might need to do it for 3 - 4 months, but it only took them 2 months to clearly diagnose me with bipolar disorder, it was type 2 at the time. I was the classic bipolar case of antidepressants triggering hypomanic episodes, for nearly 10 years since high school. That, along with my description of my symptoms and my mood chart, that showed various peaks and valleys, made them feel confident in my bipolar diagnosis.

Yes, my chart did show a significant depressive drop a few days before my period. But it also showed my mood significantly rising into hypomania in the first few days of my period. The way they explained it to me is that I did NOT have PMDD. But instead my period was a TRIGGER for my bipolar symptoms. The same way stress and lack of sleep can be triggers for bipolar symptoms.

It is very rare for a person to be misdiagnosed with bipolar when they really have PMDD. There are so many different criteria for a bipolar diagnosis than a PMDD diagnosis. Worse mood changes than normal PMS prior to your period is really the only criteria, to justify pumping you full of more antidepressants. However it is VERY common for a person to be diagnosed with PMDD when they really have bipolar disorder, because doctors will always assume mood swings are period related. But when you have mood swings at other times, or go from huge shifts in moods, like how I went from depression to hypomania within several days surrounding my cycle, it is more clear that your period is just a trigger for bipolar symptoms. That explanation really helped me A LOT.

Ironically as I get older, I get fewer and fewer symptoms before my period, sometimes none. Stress, even minor stressors, has become my primary trigger. I don’t know if that is because my bipolar has worsened (I have had several manic and mixed episodes so I am diagnosed with bipolar 1 now) or that I’m getting older. Although I am just 39, I have no idea what that means from a hormone standpoint. But I did have more bipolar symptom triggers from my period when I was younger and diagnosed with bipolar 2.

I hope that helps anyone dealing with this.

[giddykitty]

Originally Posted by tsrc78

Ugh. I know this is an old post, and I hope that you no longer have these doubts wildflowerchild. But just in case, and for anyone else dealing with this, I will offer my story.

I was actually misdiagnosed with PMDD before my bipolar diagnosis. It was assumed that just because I had severe mood swings before my cycles, it must be PMDD. Problem is PMDD is NOT just treated with hormones. They are also usually treated with....(dramatic pause).....antidepressants. Some women take antidepressants everyday, others only take them about the second half of their cycle, usually 1 - 2 weeks before their periods.

At that time my primary doc was treating me for that, as she had been for the many years I was diagnosed with depression. She referred me to a gynecologist, I think. Don’t remember if the gyn gave me anything, but it definitely wasn’t birth control. Even though we were on the path to adoption, we never stopped trying to conceive. So what does my primary doc do? Up my antidepressants, giving me an increased dose in the second half of my cycle. I was tracking my cycles anyhow, so this should have worked. Wrong. I got WORSE. It was actually because my PMDD treatment failed, as long as many years of antidepressant failures, that prompted my primary doc to finally refer me to a real psychiatric provider, and a therapist.

After hearing my symptoms, my pdoc and therapist worked together to give me a mood chart, to track my symptoms everyday, from levels of high to low. They said I might need to do it for 3 - 4 months, but it only took them 2 months to clearly diagnose me with bipolar disorder, it was type 2 at the time. I was the classic bipolar case of antidepressants triggering hypomanic episodes, for nearly 10 years since high school. That, along with my description of my symptoms and my mood chart, that showed various peaks and valleys, made them feel confident in my bipolar diagnosis.

Yes, my chart did show a significant depressive drop a few days before my period. But it also showed my mood significantly rising into hypomania in the first few days of my period. The way they explained it to me is that I did NOT have PMDD. But instead my period was a TRIGGER for my bipolar symptoms. The same way stress and lack of sleep can be triggers for bipolar symptoms.

It is very rare for a person to be misdiagnosed with bipolar when they really have PMDD. There are so many different criteria for a bipolar diagnosis than a PMDD diagnosis. Worse mood changes than normal PMS prior to your period is really the only criteria, to justify pumping you full of more antidepressants. However it is VERY common for a person to be diagnosed with PMDD when they really have bipolar disorder, because doctors will always assume mood swings are period related. But when you have mood swings at other times, or go from huge shifts in moods, like how I went from depression to hypomania within several days surrounding my cycle, it is more clear that your period is just a trigger for bipolar symptoms. That explanation really helped me A LOT.

Ironically as I get older, I get fewer and fewer symptoms before my period, sometimes none. Stress, even minor stressors, has become my primary trigger. I don’t know if that is because my bipolar has worsened (I have had several manic and mixed episodes so I am diagnosed with bipolar 1 now) or that I’m getting older. Although I am just 39, I have no idea what that means from a hormone standpoint. But I did have more bipolar symptom triggers from my period when I was younger and diagnosed with bipolar 2.

I hope that helps anyone dealing with this.

So just to clarify for myself, your PMPS. symptoms cleared up with the bipolar treatment? Or hold on, when we talk of PMDD does this only differentiate from pms.. Because of the mood?? And but then bipolar could also be the cause of those moods and not period or could it be vice versa? I'm sorry. I'm mental right now. Guess my question is just what is PMDD. Is it possible to have PMDD and bipolar or is it one or the other? Or did your doctor's not specifically say that? (These questions are coming from my need to sort this out myself. I've physical menses related pains and the moods, but the moods are in other times of the year too like as in bipolar. I'm frustrated with my docs because they are confused by my symptoms but I've been so far confused myself! They didn't ask the right questions in the beginning and now I'm being referred to an actual psychiatrist because I'm now finally thinking or getting a chance to say everything and have others speak for and about me.. I hope it gets sorted there, but I still maintain I have bipolar rather than PMDD, if one can only have one or the other) that or some personality disorder, which well, whatever she says I'll go from there. I didn't mean to full out vent to you but I've a headache from being frustrated with this process right now. Bleh :P)