Problems with one of the office staff

I’m so angry at my T right now that I don’t care if I don’t see him for a month.

I begged him to put me on Depakote to stop these symptoms. I’m suffering. He doesn’t understand. He can go home to his perfect life and I have to stay awake battling these stupid symptoms all night.

Honestly, I really wish I wasn’t alive right now. How am I going to make it through this night of agony. And on top of it, I’m burning up with the fever.

HUGS @hopealwayz your T is able to prescribe you meds? That's cool. I have to go to a Pdoc for that. Did he tell you why he wouldn't put you on Depakote? I don't think he is doing it to punish you. I'm sure there is a medical reason. I'm so sorry you are suffering. I hope you can get a bit of relief soon. HUGS Kit

He is a pdoc. That’s why he prescribes

Did he explain why those meds aren’t a good idea?

I think that he believes Seroquel would do the same thing. But they are different med classes so I don’t know why he isn’t willing to try.

Depakote is usually for bipolar disorder. Have you been actually diagnosed with bipolar disorder by this doctor?

He mentioned it to me recently following some incident.

There could be many reasons why he prefers Seroquel. One option being that Depakote can cause liver problems? From what I see at work pdocs often put A LOT of thought into what they prescribe..they consider other medical issues, potential side effect, other medications the person is taking, cost, and other off label symptoms the medications may help

Usually doctors wouldn’t just try all kind of meds on patients. That’s not the way to go as they can’t just experiment on people. They give “do not harm” oath. Now of course they make mistakes but they shouldn’t deliberately do whatever. If depakote is used on patients with BD and you aren’t specifically diagnosed with BIpolar disorder he can’t just prescribe it because you want him to. It doesn’t work this way

We can’t just decide what we think we should take. We can’t make doctors prescribe meds that aren’t suitable.

If you have bipolar disorder, one possible option (of course after talking with your pdoc) is ECT or rTMS. You might want to ask him about both treatments if you have bipolar disorder.

I don't believe she has been officially diagnosed with bipolar disorder by her treating psychiatrist.

I think I just had a manic episode for 3 days but I don’t want to tell my doctor.

You want your doctor to treat you for bipolar disorder, but you don't want to talk to him about your symptoms that might indicate bipolar disorder? You do see how illogical that is, right?

When you see him next, talk to him about the symptoms you have been experiencing. The only way he can diagnose you properly is if he has the full picture. The only way he can competently treat you for bipolar disorder is if he has a clear diagnosis based on very specific criteria that he has to see over a period of time.

Have you considered keeping a mood diary of your symptoms? Here is a link to one you can print off and use, or you can find other ones out there - even free apps for your phone: http://www.cqaimh.org/pdf/tool_edu_moodchart.pdf

I haven’t been keeping track of it but it may be difficult to explain everything that happened in those 3 days.

It was scary.

Bipolar does run in my family.

I’m also scared that he won’t take me seriously.

Why would you not want him to know? That doesn't make sense. Why would he not take you seriously?

Again, he needs data. Start charting. Let him see the patterns in your moods, sleep, etc. Without the data over time, he really has nothing to go on. He doesn't even particularly need all the gory details. He's looking for patterns in mood, sleep, grandiosity, anxiety, irritability. That's what the charting is for. Telling him about a bad 3 days won't particularly get you very far. He needs a clear history pattern to know if what he is seeing is perhaps a personality disorder like borderline personality disorder or a mood disorder like recurrent depression or bipolar disorder.

Hope, I thought you were already diagnosed with bpd by this same therapist? I don’t think you agreed with him—do you think you have bipolar instead?

That's right. I remember that now. Hope, I remember you really were upset about the idea of bpd and seemed then to be trying to grasp on to some other diagnosis -- any other diagnosis -- than bpd.

BPD and Bipolar can exist at the same time, but it sounds like your psychiatrist hasn't seen your symptoms as fully characteristic of bipolar disorder which may be why he's won't go with the depakote. They patterns you show here all seem to point with the bpd diagnosis, but if you are seeing other symptoms more indicative of bipolar disorder, you really will have to start tracking your symptoms. Bipolar episodes generally don't happen suddenly; they're kind of a slow burn into a sudden severity, and the episodes last sometimes weeks and months at a time; they are also not generally the result of events or personal reactions to people/feelings.There are exceptions to that, but that's the general idea. Part of the bipolar criteria for diagnosis has to do with the length of the episodes. Changes in mood with bpd are more sudden, shorter in duration, and more connected to reactions to events and emotions. That's why charting your moods is helpful in getting an accurate diagnosis.

Feeling manic for 3 days will not get you the diagnosis you are seeking. My t told me that under extreme stress people feel and act similar to those who experience hypomania/mania (they usually aren’t few days but more lengthy than that). I can certainly attest to that.

You might want to still tell your pdoc about your 3 day experience. It could be a symptom of many different things. He needs to know. Plus if you have these symptoms often or regularly it would help your pdoc with diagnosis

Is there a reason you want BD diagnosis? I know you aren’t in agreement re diagnosis of BPD but it doesn’t mean you necessarily have BD. I’d try to focus on symptoms and working on improving rather than diagnosis.

Not agreeing with BPD diagnosis won’t make it go away and believing you have BD won’t make it so. Focus on symptoms and follow doctors order

Your symptoms do appear to be more related to bpd: the all good or all bad type of thinking and I think constantly cancelling and rescheduling your appointments is considered to be impulsive.

I am just saying that I think it is important to work on the diagnosis that you have been given. At the same time, let him know about all the symptoms that you are experiencing, so that he will actually know what diagnosis that you are dealing with.

Diagnosis is very important especially for treatments like ECT and medication. I know and have heard of many bipolar patients and patients with resistent depression being helped with ECT. But, it won't help for other diagnoses.

I don’t want a Bipolar diagnosis.

My doctor doesn’t see what I struggle with all week between sessions. I’m having problems with PTSD again.

Several years ago, I was hospitalized and the doctor there diagnosed me with Bipolar but I never told my current pdoc.

All of my problems are not solely because of BPD. If I believed that were true, I would just rather be dead.

But then again, I’d rather be dead anyway because I’m tired of all of this.

Also, my OCD is starting to interfere in my life again and I thought that was behind me.

Any recommendations on the best way to chart?

Hope, I am not going to make any comments on what diagnosis you seem to have, may have, or want to have. What I would like to say though is that your diagnosis is what it is, whatever your doctor determines based on your particular symptoms. I also understand that you do not want to have BPD and you would rather be dead than ever admitting to having it. Believe me, I know how you feel. I was afraid I had BPD as well but my T determined I did not. What he did dx me with was worse and believe me when he said I had DID I would have rather been dead. It put me into a huge tailspin and took me months to accept. The thing is, you have what you have. Denying it does not make it go away nor does it help you work with your T on improving your symptoms. Once I accepted the DID dx I started to work on communicating with my parts, taking my meds consistently and working on DBT skills and mindfulness. All of these things have really helped me to feel better in life. I still have a long way to go and it is a struggle every day but it is better than being stuck where I was in denial.

I guess what I am saying is to work with your T and try not to fight against his dx and treatment plan. You have described him as a very competent T. Trust him. Tell him what he needs to know so he can help you.