[jules77]

Hi all,

Been a while since I've been back on here.
I have been stable for a while now with a good combination of medications.
I am a 24 year old female, diagnosed with BP 1 when I was 16 1/2 years old by my old psychiatrist. I had experienced severe depression and a hospitalization for that when I was 14, but when I was 16 I experienced horrific mixed episodes, as confirmed by my psych and therapist. I have never presented with a "true" manic episode, as far as they have understood and how I have interpreted it, though I know mixed episodes are sufficient for a BP diagnosis. These caused more hospitalizations.
While I usually experience depression (though nothing particularly noteworthy in the last few years) that caused the rest of my hospitalizations, the mixed eps were enough to warrant a dx by my psychiatrist.
I started seeing a new one this past summer (2019), and our initial session consisted of me explaining my history and he later received my old documents and labs from my former (retiring) psychiatrist I had seen for years and who gave me the dx, where the reasoning for the BP 1 dx was detailed.
I believe my current psych does not believe I have BP. I present as stable nowadays, given that my medication appears to be effective.
I want to get off some of them - I feel as though I have been on them a long time and would like to see, with medical supervision from him and my current therapist (also unsure if I have BP), if I could get off of 1 of my 3 psych meds.

Anyone else have this experience with an invalidating experience with docs who are not yet very familiar with you? This has happened as well in other hospitalizations, always getting a depression dx or mood disorder NOS. Those bothered me less, but hearing the skepticism from my current psychiatrist is disheartening. While I udnerstand and believe that dxs are used for billing and to guide treatment, I still found it frustrating and almost invalidating to hear it from him and my therapist. I may not exhibit any symptoms, but I began seeing both of them within the last 6 months or so as a stable patient.

Ugh! Just wanted to see if I got any connections on here.
Hope you all are doing as well as we can be!
Jules77

[~Christina]

I see nothing wrong with seeing if coming off one of your meds will still leave you stable. But I think you will have to allow your family or friends and Pdoc to advise you if they see you sleeping even if you can’t see it , then back on that Med you stopped.

I’m not sure what meds your on. Often people as they get older have gotten a good size tool box of coping skills so “ Some” people can cut back on meds if not all the way but sometimes lower doses at least.

What coping skills and daily healthy living are you using or doing daily to stay stable ?

[Nammu]

Ugh, that was unhelpful of those docs. Basically what Christina said. If you are rooming with anyone maybe get there help to watch for signs as we're not always the first to notice the moods. I'm also a fan of the fewest meds possible and using coping skills to manage.

Originally Posted by jules77

Hi all,

Been a while since I've been back on here.
I have been stable for a while now with a good combination of medications.
I am a 24 year old female, diagnosed with BP 1 when I was 16 1/2 years old by my old psychiatrist. I had experienced severe depression and a hospitalization for that when I was 14, but when I was 16 I experienced horrific mixed episodes, as confirmed by my psych and therapist. I have never presented with a "true" manic episode, as far as they have understood and how I have interpreted it, though I know mixed episodes are sufficient for a BP diagnosis. These caused more hospitalizations.
While I usually experience depression (though nothing particularly noteworthy in the last few years) that caused the rest of my hospitalizations, the mixed eps were enough to warrant a dx by my psychiatrist.
I started seeing a new one this past summer (2019), and our initial session consisted of me explaining my history and he later received my old documents and labs from my former (retiring) psychiatrist I had seen for years and who gave me the dx, where the reasoning for the BP 1 dx was detailed.
I believe my current psych does not believe I have BP. I present as stable nowadays, given that my medication appears to be effective.
I want to get off some of them - I feel as though I have been on them a long time and would like to see, with medical supervision from him and my current therapist (also unsure if I have BP), if I could get off of 1 of my 3 psych meds.

Anyone else have this experience with an invalidating experience with docs who are not yet very familiar with you? This has happened as well in other hospitalizations, always getting a depression dx or mood disorder NOS. Those bothered me less, but hearing the skepticism from my current psychiatrist is disheartening. While I udnerstand and believe that dxs are used for billing and to guide treatment, I still found it frustrating and almost invalidating to hear it from him and my therapist. I may not exhibit any symptoms, but I began seeing both of them within the last 6 months or so as a stable patient.

Ugh! Just wanted to see if I got any connections on here.
Hope you all are doing as well as we can be!
Jules77

Welcome back, Jules77!

I can absolutely understand how your current psychiatrist (and some hospital psychiatrists) could cause you to feel invalidated. I, personally, think they should not be uttering "I don't think you have bipolar disorder" straight from the gate. You had hospitalizations for serious mental health episodes in the past. Just because you look fine now doesn't erase your past. I do understand how a hospital psychiatrist might use the code for "mood disorder NOS". That is just a general code to use and doesn't mean that much except that they don't know for sure.

If you have been well for a while, I think it is reasonable that your medication cocktail be lowered. I'm glad to read that you're not being take off everything cold turkey. From my experience, there have been medications that were gradually removed and my quality of life only improved, or remained unchanged (not in a negative way). However, if a crucial medication is removed and sometime in the future you have mood episode breakthroughs, then it becomes apparent that maybe that medication was helpful. It's a shame that a psychiatrist has to "test if you become manic" in order to decide on a diagnosis, but it's very common.

Who knows. If I have a long period of stability and go to a new psychiatrist in the future while stable, they may even say the same to me, despite almost 10 psychiatrists (and even more therapists) confirming my bipolar diagnosis, 10 hospitalizations, years on disability, 34 years of intermittent episodes, etc. That would seem like utter insanity, to me, but it's possible. I know I've gone to new psychologists in the past that decided to diagnose me themselves in the past after most of the above. I'd shake my head. They all eventually diagnosed me AGAIN with bipolar disorder, but when they'd declare the diagnosis, you'd better believe my sarcastic thought "Oh, OK. Wow! So YOU now diagnose me with bipolar disorder!"

Of course it is possible that your current psychiatrist may have legitimate doubts.Though you are now an adult, you haven't exactly clocked many years on this planet. [I'm heading towards 50, so I can say that.] I suppose having doubts if symptoms are not crystal clear make just as much sense as being 100% sure of a diagnosis, when they aren't. Time will tell. In the meantime, I think any "test" should be done in a safe way, as you wrote it is.