[pumpernickel1]

I was diagnosed bipolar by a previous psychiatrist over 5 years ago and took different mood stabilizers and atypicals to treat it. I felt that the mood stabilizers helped. a lot. But my new pdoc doesn't think I have bipolar 2 at all. She thinks what the previous doc labeled hypo mania was actually a stress response and was an ocd flare up. When I would deal with intense, intense anxiety, often I would suddenly "flip" and would feel not depressed and clean all night and not sleep for a week at a time. The thing is, I did feel kind of euphoric but never irritable or irrational in any way. I would have worse ocd in these periods and would clean,clean,clean. But I didn't experience euphoria in the sense many others with bipolar did. It was euphoria at looking at a clean bathtub, or reorganized drawer, which I get when I don't have these episodes. There's also an element of dissociation to these episodes. I'm kind of out of it. These episodes are always induced by major stress. Anyone have any thoughts? It seems like hypo-mania to me but also doesn't.

[bpcyclist]

What about the depression side of things? Symptoms there? Anxiety? Sleep issues?

[quietlylost]

Diagnosis can be a complex thing. Sometimes it can help to write out the criteria for each disorder and then provide examples or evidence for the various symptoms to see which ones apply. There can often be overlap between symptoms and disorders.

While bipolar mood episodes can be induced by stress, they can also occur without stressors. Hypomania can be increased energy and focus, but it can also include distractability, impulsivity, racing thoughts, mood lability, grandiosity, increased social behavior, and a variety of other things. Hypomania doesn't necessarily just cleaning more and not sleeping, though those are common. When you've had those episodes in the past, how long did they last? Did they seem to resolve on their own? Were you able to self-regulate your mood and utilize coping skills or did the mood persist despite your efforts? Did depression follow the period of hypomania? Were you on medications at the time? What was your sleep like before the episode?

With the possibility of OCD, there are usually a number of other symptoms like intrusive thoughts, compulsions, anxiety, or behaviors designed to diffuse anxiety. Sometimes that can include rituals, but a lot of times it is focused on mental activities that take a lot of time and effort. How often do you have intrusive thoughts? What are those thoughts of? Do the thoughts cause discomfort? Why? What do you do to diffuse the thoughts or manage your anxiety? How long do you spend each day dealing with these thoughts? Are the thoughts specific such as a phobia or are they generalized?

It's not uncommon for providers to disagree on diagnoses, especially with Bipolar Disorder. There's a significant bias against the diagnosis and many providers will not diagnose it unless they see you actively manic. It can be important to share your past experiences and explore the diagnosis further with the provider. What are they seeing that makes them think OCD? Why are they resistant to the idea of Bipolar? If you can get records from a past provider that can help as well.

Whatever happens, diagnosis and treatment are a process. It's important that you get your needs met. If your provider isn't meeting those needs, it's okay to let them know or to seek someone else out instead. Good luck!

[Soupe du jour]

Hi pumpernickel. Welcome to this forum!

I think another psychiatrist (or psychologist) opinion might be a good idea since you've only had two psych evaluations and they seem to conflict. Suggestions above seem wise. I also think it is significant that you've found some benefit in the past from bipolar medications. How did those medications help you exactly? That's a good point of discussion.

[Fuzzybear]

I agree that diagnosis can be very complex. Thanks for sharing here.

[bpcyclist]

Originally Posted by quietlylost

Diagnosis can be a complex thing. Sometimes it can help to write out the criteria for each disorder and then provide examples or evidence for the various symptoms to see which ones apply. There can often be overlap between symptoms and disorders.

While bipolar mood episodes can be induced by stress, they can also occur without stressors. Hypomania can be increased energy and focus, but it can also include distractability, impulsivity, racing thoughts, mood lability, grandiosity, increased social behavior, and a variety of other things. Hypomania doesn't necessarily just cleaning more and not sleeping, though those are common. When you've had those episodes in the past, how long did they last? Did they seem to resolve on their own? Were you able to self-regulate your mood and utilize coping skills or did the mood persist despite your efforts? Did depression follow the period of hypomania? Were you on medications at the time? What was your sleep like before the episode?

With the possibility of OCD, there are usually a number of other symptoms like intrusive thoughts, compulsions, anxiety, or behaviors designed to diffuse anxiety. Sometimes that can include rituals, but a lot of times it is focused on mental activities that take a lot of time and effort. How often do you have intrusive thoughts? What are those thoughts of? Do the thoughts cause discomfort? Why? What do you do to diffuse the thoughts or manage your anxiety? How long do you spend each day dealing with these thoughts? Are the thoughts specific such as a phobia or are they generalized?

It's not uncommon for providers to disagree on diagnoses, especially with Bipolar Disorder. There's a significant bias against the diagnosis and many providers will not diagnose it unless they see you actively manic. It can be important to share your past experiences and explore the diagnosis further with the provider. What are they seeing that makes them think OCD? Why are they resistant to the idea of Bipolar? If you can get records from a past provider that can help as well.

Whatever happens, diagnosis and treatment are a process. It's important that you get your needs met. If your provider isn't meeting those needs, it's okay to let them know or to seek someone else out instead. Good luck!

Great remarks!! I would only add that the average accurate bp diagnosis is delayed 8 yrs from symptom onset. Very difficult to correctly diagnose. As much as it may be overdiagnosed, it is more than equally underdiagnosed IMHO.

Huhggification.

[bpcyclist]

Originally Posted by Soupe du jour

Hi pumpernickel. Welcome to this forum!

I think another psychiatrist (or psychologist) opinion might be a good idea since you've only had two psych evaluations and they seem to conflict. Suggestions above seem wise. I also think it is significant that you've found some benefit in the past from bipolar medications. How did those medications help you exactly? That's a good point of discussion.

Huhggification.people without bp shld derive no benefit from mood stabilizers.