Session update

I had a productive session last night and learned something new. T and I talked about how I feel that my moods have been cycling. I guess they always have been but I hadn't made the connection until recently.

I go from irritable to angry and then kind of hyper and impulsive and somewhere in there is depressive moments too. Reducing my meds on my own is what brought this to light for me.

My T has seen the same pattern and told me to look up cyclothymia. I did some prelim research last night and there seems to be fine lines between this and various stages of bipolar. I don't think I am bipolar after what I read but

I need to see my p-doc and can't until the 10th of August. I just called again today. I felt like saying 'okay I'll just cycle until then' But I didn't.

What confuses me today is that between my T and p-doc I've heard the following regarding diagnosis:

My T: Major depression, PTSD, ADD, traits such as hysterical, dependent, obsessive, and now cyclothymia meaning hypomanic episodes.

My P-doc: OCPD (T disagrees), ADD, depression

I trust my T's assessment far more than my p-doc. I hardly know her and only see her 15 minutes at a time. I usually can't get a word in either.

I guess I'm wondering now if the real diagnosis is ADD and cyclothymia. I did read that it is hard to pin point someone's true problem until sufficient time has gone by and symptoms, behavior etc. can be noted. I've been with T well over a year and a half.

I'm hoping this is my answer. I don't want to cycle like I do anymore.

I find it frustrating that I have a T and a p-doc. How much should they be communicating with each other? I forgot to ask T that last night. It seems to me that critical information comes out in my sessions and with my p-doc its a med check only.

I'm frustrated...

The big thing is that in a lot of cases here the meds aren't that different.. with maybe ADD being the difference, so it depends on how important a dx, name or label is to you. i've known many people whose dx have changed depending on which pdoc they see. Is your T a psychologist? A PhD here where i am is licensed to test someone using this test..shoot...um Minnesota Multiphasic something or other.. which is like a 2 hr test. Maybe you could be referred just for testing if not?

Like i said though, with OCD, cyclothemia, BPII the meds are pretty much the same. If you do have OC traits you might want to try clomipramine as an AD if you go that route, it's shown the best results for OCD.

hope you find the answers you need

much love and peace

Yes my T is a clinical psychologist and he did perform testing when I first came to him. Major depression was the diagnoses and then ADD added about six weeks later.

In time, my lovely personality traits surfaced with him and then I began seeing a p-doc rather than my family doctor for meds. She indicated the OCPD somewhat...

I just read that ADD and major depression can be a misdiagnosis initially...I'm really wondering about all of this now. This is why therapy is so important. If this is true for me, it would never have surfaced if I wasn't in therapy until something bad happened.

I've been asked manic type questions by my p-doc. I guess I wasn't the best person to answer those questions. I really never thought I was any form of bipolar. I knew I had ups and downs but just thought that was major depression.

I feel stupid now.

Thinking of you alemda. DX are hard and they are just opionions. There are fine lines between the different dx's. I don't think the dx is as important as we make them. The real thing is to help the symptons. I am sorry you are struggling so much right now.

(((((((((alameda24fan)))))))))

if thats ok

I agree the focus is on symptoms but I think the DX is sort of critical in a way isn't it?

I'll explain. I've been on Prozac for almost two years now straight. It has helped me but not on the cycling part which I am just realizing now is something different. So I never mentioned the cycling to my p-doc because I thought that was more an issue to discuss with my T.

If I am not ADD but in fact do have a form of bipolar then I shouldn't be on adderall necessarily right?

Alameda -

I think the dx does serve a purpose but we should never live and die by them and a lot do. If you aren't ADD then you shouldn't be on adderal. That is where I think the dx gets mixed up - oh see she has this symptom so she must be x - well maybe not lets look at all the symptoms and kinda of watch for a while to see what goes on and then see the best avenue. I just think we are to quick to jump to a dx and that can be harmful. Dx are important to a certain degree, I just wish Dr. would be more careful. If you have a form of bipolar I could see how some of the symptoms may have looked liked add and the add medicine will not help bipolar, but a bipolar medicine would be beneficial.

I am so sorry that you are going through all of this. It sucks. Do your T and P Doc talk? I hope that this gets figured out soon for you. Please know that I am thinking of you.

Thanks everyone! I don't disagree with the ADD diagnosis because the Adderall has helped me in the focus/concentration area a lot.

I'm wondering though if T is right regarding cyclothymia, I wonder how the p-doc will view my medication options. Going off of adderall = forget passing my exams and getting those certifications I need for my job...

((Almeda))

Sorry you are having such a crappy time.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
I find it frustrating that I have a T and a p-doc. How much should they be communicating with each other? I

</div></font></blockquote><font class="post">

I remember when I first saw pdoc for consultation on my depression and asked T if he had heard from him and he said the pdocs rarely call unless it's an unusual case.

As far as the different dx's go, my T dx'd me with dysthymia and my pdoc with major depression. I think that the dx is important as far as prescribing correct meds is concerned. But in T's case, he is treating the symptoms.

This is not at all unusual. My sister in law is a T and she said that she never has the same dx as the pdoc.

I hope you are feeling better soon.

My pdoc and T will talk when I ask them to or if something comes up. The pdoc likes to hear from T, but T usually has to make the call.

As far as meds go - I take meds for ADD and bi-polar. I'm not sure if ppl are thinking you can't take meds for both at the same time, but I do and it seems to work without conflict.

I can't get a straight dx either. Both the T and pdoc don't like using them. So I've heard lots of different things: anxiety (this seems to be agreed upon), bi-polar, major depression, ADD, and then there's discussion about BPD with T, but T doesn't want to call me that though I see more and more of myself there - maybe not strong enough to be BPD though. Dx get confusing. Sometimes I wish we could just say - I have X so I'll do/take Y and everything will be OK. Doesn't seem to work that way - we're way too complicated.

almedafan, that's great you had a productive session.

Diagnosis is not that important to me (or my T). I think that if the adderall is helping you and you want to continue with it, then it doesn't really matter if you have a diagnosis of ADD. Just stick with what is working. (Personally, I would like to try adderall.) I wonder why your T is so concerned with diagnosis? Is he worried you are on the wrong meds? I think it sounds good that your scaling back of the meds has made you more self aware (of your moods). That sounds very positive to me.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
I guess I'm wondering now if the real diagnosis is ADD and cyclothymia.

</div></font></blockquote><font class="post">
Maybe there is no real diagnosis. How will your diagnosis change T's approach in therapy with you? Or do you want the "real" diagnosis as help in choosing your meds?

</font><blockquote><div id="quote"><font class="small">Quote:</font>
I'm hoping this is my answer.

</div></font></blockquote><font class="post">
There may not be one right answer. The human is a complex organism. It's hard to divide us all into dozens of sometimes artificial categories. I think an important question is what use you will make of a diagnosis, as that should drive the need to have one. For myself, I would not make use of a diagnosis, so I do not request one from my T. What he is doing with me is helping me, without a diagnosis.

Hey everyone! I see the point now on the whole DX concept. I guess for me, I was thinking that a DX would help with the meds.

I don't need a DX from T at all. He's working wonders with me just the way he's doing things. I should've clarified that I was referring to picking the right meds.

Although, our bodies build tolerance and eventually we're on to another med anyway. The adderall is a great example. I needed very little when I first started taking it. Now I take 30mg/day and that doesn't help me into the night when I'm studying as well as it does during the day when I'm working...

A never ending cycle. I wish my T could prescribe that is why I am frustrated by the having both of them. My T has all of the key information about me and my p-doc doesn't.

With the p-doc it is a 15 minute med check visit only. I called though and said I need a longer session and we need to talk about some recent developments. I can't see her until Aug 10th. At first it was Aug 16th but when I said I'm open then on the time, the 10th was still all she had.

So I'll just keep cycling...if my T could prescribe I'd be well on my way by now...that to me is frustrating. In fact, his medication recommendations are usually not wrong but one time I mentioned one to my p-doc and she got upset.

She said something like 'he's a psychologist right? I said yes and then she said 'so he doesn't handle medication right' and I said yes and then she said 'good, I just wanted to make sure that you are clear about that'

I wanted to quit her right then but I'm giving it some more time because that was the only real complaint that I had. I'll re-evaluate after I see her on the 10th and become more CLEAR with her.

Almedafan, it does sound like it would be most efficient if the therapist and pdoc could consult with each other. I think sometimes they do? I'm sorry that yours don't. How frustrating. (((hugs))) I hope you can hang in there until your August 10 meeting with your pdoc, and that your appointment will be productive.

I take one rather benign med and it isn't working anymore. So thanks for the info on tolerance--I didn't know about that. Do you know, does tolerance go away if you quit the med for a while and then start up again? Like, could you quit adderall for 6 months, start it again, and only need the very low dose again at first?

Actually with Adderall yes, it's called a drug holiday. It isn't easy to do though because I study on weekends and nights during the week.

I could take off on Saturday's then I just need to deal with the tiredness.

I'm not sure about AD's though. I just know with Adderall many people take time off of it. Now some doctors don't recommend that because they say it is still working in the brain even if you feel like it isn't.

I agree that they both need to talk. I'm sure my T isn't the problem it is her. I'm going to tell her that she needs to contact him regularly and if she is not doing that then she isn't helping me at all.