[Nola0250]

Just interested in your thoughts. My pdoc diagnosed me type 2 bipolar last year. He said I wasn’t type 1 because my mania didn’t last 2 weeks and was not that severe. I was able to keep working and hide my symptoms (barely). The fact that I felt as if electricity was going to spark out my fingertips didn’t concern him for type 1 because I knew it was not actually going to happen. Visual and auditory hallucinations I had as a teenager (I’m nearly 50 and have had only glimpses in the last year, otherwise haven’t had any) were not significant because I knew they were not real. Then a couple months later he put me in Latuda and said he was using it even though I’m type 2 because it’s good for bipolar depression and that’s my major symptom.

My T says type 1 because even though I was only really manic for about 4 days, my overall mood was quite up/irritable with a lot of sleep disturbance for well over 2 weeks and that even though I haven’t lost my job, been arrested etc, that the impact of bipolar on my life has been quite significant which is true.

I figure she’s right and my pdoc didn’t say it because the label doesn’t really matter and he probably didn’t want me to freak out and refuse the medication.

Thoughts?

[Victoria'smom]

Your life doesn't have to fall apart to be type 1. I hide well even in my psychosis. What matters is that it's Bipolar and he's treating your symptoms. I was told by my first Pdoc that I couldn't be BP because I could think about consequences for my actions. There's a lot of ill informed people including dr.'s and therapists.

[Pookyl]

Personally I would take the word of a pdoc over a T any day. A pdoc is more qualified than a T.
That being said, if your illness is being treated properly, labels don’t matter so much.

[Nola0250]

I agree, the labels don’t really matter. I’m just curious because I thought myself that I was a type 1. I suspect my pdoc was afraid I’d freak if he said type 1 when I was first diagnosed. Seriously I’ve had enough hallucinations obsessions and intrusive thoughts as well as paranoia. Also I’m a professional working in a fairly high level job and he may have been trying to protect me from a diagnosis that might be even more career damaging if it got out.

[Pookyl]

I wanted to add that I worked as a health professional for 25yrs. I never met anyone who deliberately gave a patient a wrong diagnosis. If your pdoc believes you have Bipolar 2 then that’s what he believes. If you disagree with your diagnosis it’s definitely worth discussing it further your pdoc.
I’ve had many an argument over my diagnosis with my pdoc

[Guiness187055]

Ultimately it does not matter. They are both treated the same way.

[Blueberrybook]

It really doesn't matter if it's Type I or Type II. It's still bipolar, and it is treated the same way. If the pdoc starts to feel differently, he will change the diagnosis.

I recently got medical records from my clinic because my old pdoc of 10 years is retiring. They will change their diagnosis if they feel it is not correct. First, when I saw my doctor, she diagnosed postpartum depression with panic disorder. Then to major depression, but that was like only one visit. Then, she had me diagnosed as bipolar I? bipolar II? I was bipolar type? for several visits. I had the bipolar II on my diagnosis sheet until she changed it to bipolar 1 after I had a huge manic episode in her waiting room and office (not on purpose, it was actually a scheduled appointment). And it wasn't even hallucinations or psychosis (if there was psychosis, it was mild) though I had a lot of that automatic handwriting stuff, couldn't stop for hours at a time., I forget what's called. And just very, very extreme mania. She wanted me in the hospital, but ultimately H came there, and things got under control once I started sleeping better; she prescribed something stronger for sleep, and I had to go back in a couple days' time. After that she left it bipolar 1. It may seem every visit I had, I got a new diagnosis, but really, this is over a 10 year period of time, and new things would come to light for her.

The new pdoc I have seems to think it has been bipolar 1 mixed awhile now. I got the beginning of his notes for me when I got the treatment records at the clinic; he is at the same place as the old pdoc. After first, I thought, no, he can't be right. No way am I mixed. But then the more I read about mixed and the symptoms, I realized he was right. My old pdoc only once told me my actual diagnosis (I didn't ask), and that was after the manic episode she witnessed. Even if she hadn't witnessed it, if it had gone on, H would have brought me there as urgent or to a psych ER it was so bad.

So sometimes a different pdoc will give a different diagnosis or your diagnosis changes over time, depending on things that happen.

[Movingon69]

My pdoc hasn't even told me if she thinks I'm 1 or 2. I don't even feel like I need to know. However, I've had psychosis.

I understand your frustration, Nola. Sometimes it comforts us to know exactly what's going on, so I get where you're coming from.

I personally think that doctors are reluctant to diagnose BP 1 right away because they aren't sure about the "severity" of a person's upswing symptoms during the initial stages of diagnosis. I think they need to give themselves more time to analyze the "up" symptoms before they hand out the label of BP 1. But that's just my uneducated guess.

If you want, you could always have your therapist share her notes with your pdoc if you want your pdoc to change the label. And despite what people say about the label "not mattering," that's not always true. My insurance kept rejecting my rexulti until it was proven that I had BP 1 with psychotic features. When I just had a plain BP 1 label, they were all like, "nope, you don't need it. This is primarily meant for psychosis. Find something else." Then when my psychosis was mentioned and the label changed, "oh, wow. Looks like you really do need it!!"

Maybe you're Bipolar 1.5. People surely do reach the mysterious cusp.

[Nola0250]

1.5! Cute.

I know type 1’s may be more severe but also may have long periods of stability. I could use one of those right about now.

[BipolaRNurse]

I'm type 1 and I enjoy long periods of stability. The only times I lose my $#!+ anymore is in the early spring, and sometimes in the early fall. We've dealt with the depression with ADs, thyroid medication, vitamin D and a light box, and we're handling the mania with APs and mood stabilizers. I do quite well the vast majority of the time.

But it wasn't always that way. I used to be a hot mess. In the beginning, I was diagnosed bipolar NOS and I got kind of fixated on having a number, which my pdoc was unwilling to provide as he couldn't quite figure out what "flavor" I had. Then the hospitalization happened, and BOOM, here comes the bipolar 1 diagnosis. I have since been re-diagnosed BP 1 three more times, so I've had to accept it even though it was a shock at first. But like other posters have said, the numbers really don't matter so much because the treatments are the same, and good doctors don't treat diagnoses but symptoms.

[Nola0250]

Yeah, I know. I’ve just been thinking well if I was a type 1, where’s my period of stability? It’s been a year since diagnosis. Still waiting and hoping for that. I keep thinking I’m getting there, then BOOM. And yet another med change. Haven’t got it figured out yet. I hate drama but it seems to be the nature of my existence

[Pookyl]

Originally Posted by Nola0250

Yeah, I know. I’ve just been thinking well if I was a type 1, where’s my period of stability? It’s been a year since diagnosis. Still waiting and hoping for that. I keep thinking I’m getting there, then BOOM. And yet another med change. Haven’t got it figured out yet. I hate drama but it seems to be the nature of my existence

I don’t have the answer but I wanted to let you know you’re not alone. I was diagnosed 4 years ago as Bipolar 1 and I can count my ‘stability’ periods on one hand. I do all the right things but still I’m unstable. My pdoc has said that I have a very brittle form of the disease.