Confusion

Therapist thinks I'm bipolar, pdoc thinks not. This debate between them is confusing and stressful and scary. And it doesn't even matter! My therapies are supposed to be helpful for depression or bipolar so giving it a label isn't a priority. Regardless I'm freaked by the whole thing. Just wanted to vent. Ugh.

Hopefully they can get on the same page for the best treatment plan.

Have you told them that it isn't important to you? If not they might think they are helping. I guess to some it is helpful some not. Are they trying to figure out what meds if any would be best? It is your wellbeing that is important though so if it is stressing you out then it is important that they know about it. Take care

My pdoc said that the dx isn't important since my treatment is appropriate for either and that it will be altered based on whatever is going on with me presently. Idk why my therapist felt this way but i got the feeling last session that she wanted to see what the pdoc said before she would engage in therapy. It was weird

What kind of medications is your pdoc having you take?

Have you ever been manic or hypomanic?

The thing is, your therapist getting this wrong matters less than your pdoc getting it wrong. If your therapist is good and you are helped by your time with them, having the exact right diagnostic label is not crucial to the process. OTOH if your pdoc is medicating you as though you have anxiety or unipolar depression and it turns out that you are actually bipolar, that is potentially very harmful.

I guess my pdoc doesn't think I have been manic or hypomanic. It's hard by to say bc the times I've felt really up and euphoric are very short periods and the times I'm most likely to call manic I describe more of extremely angry and antagonistic. I'm not convinced either way either but I feel like the description of bipolar describes how I feel better. Idk tho. I refused antidepressants so I'm on lamictal, gaba, and buspar with she said are good for bipolar anyway.

I hardly ever feel happy or euphoric. My hypomania manifests itself as extreme irritability. I go into what I like to call "troll mode" and I become highly unpleasant. I don't get productive or energised in a positive way, I get racing thoughts that mostly make no sense and a pressure to keep talking and say whatever comes into my mind - basically, my filter goes. Everything I think actually comes out.

A hypomanic episode doesn't have to last longer than four days. Mine usually last about a week or so.

I mostly experience depressive episodes, so I'm on an antidepressant (sertraline) as well as Lamictal. The latter is an enhancer and works well in combination with an SSRI for those of us who mainly struggle with depression.

I'm definitely depressed most of the time. Idk what's happening the other times. I probably don't qualify for any diagnosis and that's fine. I just want to know what's wrong and how to fix it 😢

To me it sounds like you qualify for a diagnosis of bipolar type 2 (though of course I can't be sure). And I don't know why you refused antidepressants, but your symptoms sound very similar to mine and I would certainly recommend an SSRI in addition to the Lamictal, because, like I said, lamotrigine works as an enhancer. That could be worth talking to your psychiatrist about at your next appointment.

I refused the ADs because some made me feel foggy and slow and some made me extremely angry and uncomfortable like I was trapped in a body that limited me. They also made me unable to access my favorite part of my brain so I couldn't deal with that. I just don't understand the bipolar spectrum or what determines what is mania. My head is spinning.

I'm sorry you had a bad experience with antidepressants. Have you tried all the different types? SSRIs, SNRIs, MAOIs, tricyclics? How many different SSRIs did you try? Were you on the antidepressants in combination with the other meds you are currently taking?

As for what mania, or hypomania, is, I guess you'll have to describe to your psychiatrist what you are experiencing. For me hypomania is irritability, pressure to keep talking, speaking without a filter, doing impulsive things like spending money on unnecessary stuff, constantly feeling the need to yell at people (and occasionally doing so), feeling jittery and on edge, an inability to sit still (like I can't stop my foot from tapping, etc.), can't make sense of the thoughts in my head like it is indeed just spinning around nonsensically, and so on. But everyone's symptoms are slightly different, and occur to varying degrees. The bipolar spectrum is very wide, but if any of this resonates with you, definitely see your psychiatrist and talk to them about it.

TOTALLY understand where you're coming from. You're right - therapy and meds should work on the symptoms, not the label. As far as I'm concerned (because I'm so wise and all - haha), diagnoses should only be used for reporting to insurance companies.

Except the bipolar diagnosis can preclude use of certain meds that could help straight depression but set off mania in someone with bipolar disorder, so the diagnosis can be significant to medication treatment. That said, the OP's meds sound very in line with bipolar med treatment. It might be a case where the pdoc is still in the phase of ruling out a bipolar diagnosis. That can take awhile.

Except Ellie says "My therapies are supposed to be helpful for depression or bipolar so giving it a label isn't a priority."

I'm writing an outline of my life. My T and pdoc can do their shrinky thing and I'll just go eat some ice cream.