[tecomsin]

I know that the standard answer is that a person can have more than one diagnosed mental illness due to meeting the criteria for each one, specifically.

But if you think holistically about a person and their mind, there seems to be just a niggling of a problem.

For instance,
I have been diagnosed at times of having GAD but I really do think my tendency to anxiety is part and parcel of my bipolar or sza, whichever it is. It's one way my illness can interfere in normal life.

I am also paranoid sometimes but not enough to meet a diagnostic criteria for another mental illness so my paranoia is just lumped in with being a symptom of bipolar.

To me the distinction between labelling anxiety as . a separate illness and not labelling paranoia as one is pretty arbitrary.

That's why I think it is just one mental illness that I have.

[Pookyl]

My anxiety predates my bipolar diagnosis by approx 30yrs. So I consider the diagnoses of anxiety and bipolar separate.
I originally started with GAD followed by panic attacks then by claustrophobia then by agoraphobia.

[TheSeaCat]

I believe I have more than one mental illness, my anxiety also predates my Bipolar diagnosis by a month. My GAD also makes me have panic attacks, I don't think that is a component of Bipolar but rather that of my anxiety.

My PTSD is also a different diagnosis than my Bipolar or Anxiety, sometimes my anxiety makes my PTSD worse; but I still think of it as a different diagnosis. So I have three mental illnesses that all have different symptoms, sometimes one condition makes the other worse, but I consider that a rarity since they are all being treated by medication and therapy.

[Merlin]

I have Bipolar Disorder, Social Anxiety Disorder and the remnants of PTSD. I have no doubt that they interact with each other, but they’re distinct illnesses.

[~Christina]

I think Bipolar is a umbrella for many issues.

I have never met a person with bipolar that doesn’t have......

Insomnia
Anxiety
Panic (same thing too)
GAD ( same thing as panic )
Extreme mood shifts
Self esteem problems
Often PTSD

I don’t think they are all side diagnosis. Just part of Bipolar

Just my opinion of course

I have 3 officially diagnosed, though I'm pretty sure I have a 4th (or at least trates of a 4th)

they seem to think so too

[MickeyCheeky]

Well, diagnosis and labels are arbitrary. But I do believe one can have more than one mental illness, just like one can have more than one phyisical problem. Hugs to everyone who's struggling

[tecomsin]

I also agree that the labels are arbitrary in many respects, but they are what we have and once we have been given a label it is bound to affect how we experience life too.

In my mind, unlike the body where we can experience pain in different parts at different times, I only get one experience out of my mind at a time. I don't think my hippocampus is in pain. I think I am in pain, or anxious, or paranoid.

I also wonder the degree to which I was already bipolar before my first breakdown in my 40s. I don't think it sprung out of nowhere. I was already ill but functioning as a productive member of society. Now i am not, partly as a result of getting all these labels. Once my psychiatrist wrote in a letter that I saw later that I had 'traits of histrionic personality disorder'. When I asked him about it he said that traits mean you don't have the personality disorder, you just have traits. So I didn't get that label but it is in my copious notes if anyone were to look.

But I also don't think I am the sum of all that is in those notes or that knowing what is in there will help me get to healing.

I appreciate everyone's perspective. It helps me understand my own. I think how we think about mental illness(es) affects how we experience our own.

My overwhelming experience is that it is one state of consciousness that I have and one focus of attention at each moment so i don't know how to parse that time series into distinct, disparate categories of mental illness.

I have multiple diagnisoses. Anxiety, depression, learning difficulty and OCD.

I have had short-term mental health issues like minor specific phobias and agoraphobia. With therapy (like exposure therapy) they were resolved. I have also had more generalized anxiety at times in my life without clear bipolar episodes. That anxiety comes and goes. At times I have no anxiety. There are times when I have anxiety with bipolar symptoms. I think it's a bit different. My doctors and I feel that bipolar type 1 is my constant main diagnosis. Right now that's all I say I have.

Unlike some other mental health issues, I believe bipolar disorder can't be cured, but can be in remission for various periods. I'm not certain if I will ever have the specific phobias or agoraphobia symptoms again. I do believe anxiety will rear its head again. The phobias were clearly triggered by trauma or similar. The bipolar and tendency towards my anxiety seems to be more genetically based, I believe.Though my episodes can often be triggered, at other times they don't seem to be. Or at least not by much.

[Gabyunbound]

My anxiety diagnosis pre-dates my BP one, but my BP one was a long time in coming, so they may well coincide. One has to keep in mind, that symptoms don't always coincide perfectly with diagnosis: you may get diagnosed later, whether months or years.

I agree with you that some diagnoses that are diagnosed separately are really part and parcel of one (in this case BP and GAD, but I think it can happen with other diagnoses where there is a primary one and then others). As you say, it just makes sense. Though I don't think it's the case for everyone.

[tecomsin]

It wasn't until I had quite a lot of therapy that I became aware of some of the problems I had with boundary violations. I would cross other people's boundaries without being aware of the implications of doing that, or what it actually meant. Ithought some times I had a right to take out my feelings on other people around. This is the environment I was raised and helpless as a small child. I think the anger comes from feelings of helplessness.

It is also why it is so difficult for me to make good choices about who to involve in my life and why I live alone, except for my son who is moving out and occasional outing with a friend.

I think relationships are even more problematic for me than the usual person with bipolar because of what I learned and didn't learn as a small child. i grew up in a violent environemtn with a lot of fighting where I was also physically abused by my mother and father. My father is an alcoholic bipolar with a history of violence against women and adultery when he was married. As an adult he would intrude in my life and cross all kinds of boundaries by calling people at my workplace out of the blue because of his 'concerns' about me. I worked in a large organization and would get emails from people I didn't know to 'call your father because he is concerned about you'. It was extremely embarrassing. My father had threatened he would do this if I didn't tell him the full name of the man I was involved with, so it was emotional blackmail. After that I cut him out of my life entirely. Still he called me against my wishes the day before I went in for lung cancer surgery despite my telling him once and for all to not contact me anymore. My sister eventually did the same with him. My mother is long dead, was chronically abused and depressed and took out her frustrations on me as a small child, she would poke a broom under the bed to hit me when I ran away to hide from her and do other awful things. My sister had a totally different experience with my mom and didn't get any abuse like that.

Well all I can say is that I didn't have good models in my life to have healthy relationships. I don't know how much my deficiencies in relationships is due to the bipolar, how I was raised or some combination. I can see that lots ofpeople here do much better in relationships than I do, because they have long, enduring ones of mutual respect.

Sorry for the rant!

[Carmina]

Personally I think to an extent we are still dealing with the by products of outdated and largely pseudo scientific psychiatric diagnostics which has always tended towards classification based on symptoms rather than an understanding of underlying aetiology. With the advent of trauma informed diagnostics, and a more subtle understanding of the complex interaction between developmental and genetic factors that is beginning to change but the change is slow and there's lots of inertia. In the old system symptoms become elevated to the level of illnesses; for example anxiety and depression are both symptoms, to elevate them to conditions in themselves is rather like calling an illness 'pain disorder' - as with the symptom of pain, anxiety and depression (and many other mental health symptoms) reflect underlying issues that on a deeper level may well be seen as a unified whole, rather than a separate collection of disease entities. While occasionally it may be valid to erect a disease entity of say 'chronic pain' in reality that sort of symptom level construct indicates that the underlying causes of that pain are largely unknown, once the causes are known they would be the more appropriate diagnosis (eg chronic pain as a result of fibromyalgia, or arthritis etc).

[tecomsin]

You raise many good points, Carmina. It isn't a perfect analogy but I tend to think of modern diagnostics as colours of paint on a canvass, but a complete description of all the colors doesn't tell you what the painting is about.


Also, in terms of what qualifies as illness, mental illnesses are supposed to be in some sense disabling versions of what other people might experience on a mild or occasional basis.

But what has done the most damage to my life has been the difficulties I have with relationships and personal boundaries, not the psychosis, mania or main symptoms of bipolar. Maybe that's how I picked up the 'traits of a personality disorder' in a diagnosis by my psychiatrist. I think it has something to do with all the legal problems i had last year that ended me in forensic detention for a month last year. It is hard not to look at that and see some kind of failure. It is also a failure of a community that chose to treat me like a criminal.

That is also where I would expect to see healing if healing were to occur. I have a better relationship with my son now than before, but this is the only close relationship that has survived. I simply don't trust anyone else to have my best interests at heart.

[Blueberrybook]

Originally Posted by tecomsin

I know that the standard answer is that a person can have more than one diagnosed mental illness due to meeting the criteria for each one, specifically.

But if you think holistically about a person and their mind, there seems to be just a niggling of a problem.

For instance,
I have been diagnosed at times of having GAD but I really do think my tendency to anxiety is part and parcel of my bipolar or sza, whichever it is. It's one way my illness can interfere in normal life.

I am also paranoid sometimes but not enough to meet a diagnostic criteria for another mental illness so my paranoia is just lumped in with being a symptom of bipolar.

To me the distinction between labelling anxiety as . a separate illness and not labelling paranoia as one is pretty arbitrary.

That's why I think it is just one mental illness that I have.

Yes, I believe so. I have the bipolar, but it didn't fully manifest until my mid-20s. Before that, I had severe anorexia (the type you see the horrible pictures of), and it is definitely a place no one wants to go, one of the worst ways to live and waste your life, you think about nothing but food, calories, exercise, clothes sizes, bones, your weight, restricting food, that you are fat, how much you weigh, scales, which scales are most accurate, etc., etc., etc. probably 95% of the time. I'd walk a grocery store for over an hour just looking at the food and leave maybe after purchasing some apples. I hoarded food under my bed (not that I ever ate it). I had weird eating rituals. It is pretty much a lifestyle when you get that absorbed in it. I even dreamed about eating things like chocolate cake slathered with icing or a whole bag of M&Ms and each time woke up feeling like i had to either try to throw it up (which I sucked at and did not go the bulimic route) or do an aerobics tape at 2 AM in the morning.

Anxiety and panic may tie in with bipolar, even the ED if you think holistically, but I think they are separate things, as is PTSD (so many back flashbacks and such different causes).

But I do think all disorders can be hit at once like by stress, a medical emergency, alcohol, meds, etc.

[tecomsin]

Originally Posted by Blueberrybook

Anxiety and panic may tie in with bipolar, even the ED if you think holistically, but I think they are separate things, as is PTSD (so many back flashbacks and such different causes).

Yes i agree they are different. The question is not whether they are different in terms of symptoms, but whether one person really can have multiple mental illnesses at the same time.

Well I am just throwing the question out there and appreciate all the responses and the thoughts that go into them.

[Victoria'smom]

My old Pdoc only diagnosed Bipolar. He said everything else stemmed from BP including my eating disorder. I don't know what my Dx is now. I liked that pdoc. He was into natural remedies before psych meds and looking out for quality of life vs. leaving you with side effects because it makes you "better".

[annielovesbacon]

As many others have said, my anxiety diagnosis predates my bipolar diagnosis. To me, they are separate, because I have medication that keeps my anxiety under control, but I am still struggling to find the proper medication for bipolar disorder.

My eating disorder predates all other diagnoses by many years. They say that, in general, bipolar starts rearing its ugly head when you become a young adult. I know that's not true for everyone, but it was for me. I have struggled with an eating disorder since I was 13. So to me those are separate as well.

I can see what you mean, though, when thinking of my substance abuse problems. I probably would not be an alcohol and an addict if I did not have bipolar disorder. I'm not sure if those are two separate things or not.

[still_crazy]

I lean towards...if there's severe mental illness on board, focus on getting that under control, then see what happens, keeping in mind that the drugs used for many problems can cause problems, too (lethargy, low mood, inability to concentrate, etc.).

in my early 20s, i was given involuntary shock 'treatments' (clearly, not a fan) at a 'well-regarded' psych place. i didn't give consent or anything, they just...went to shockin' me, like it was the 50s or something. anyway...

their 'expert diagnosis' was "mild Schizophrenia" 24/7, then "Bipolar I, current episode severe mania," which apparently had only recently developed. thing about that is...

as with many "pissed off mental patients," I've come to find that a lot of this is not just pseudoscience; its control masquerading as science. my diagnosis is now "Bipolar I," after multiple changes to the diagnosis depending on who was diagnosing and (this seems to be the big thing...) how much $$$ they could get and my perceived social class.

at this point...I think they settled on "Bipolar I" because I'm dependent on disability (usually, I think that means "Schizophrenia" or "Schizoaffective"), but I'm also taken care of by an "upper class" (not rich, but above middle class) family, plus my IQ is high enough to make a case for Bipolar I, I guess.

OK. point is...psychiatry, as a whole, is decidedly not scientific and increasingly not all that interesting intellectually, either. -all- the labels are subject to change, so try not to get too caught up in what any 'expert' has to say about you...

try to get what you can out of treatment and have the best life possible.