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Until my most recent episode when it became clear that my psychiatrist was going t have to write bipolar disorder, my psychiatrist was putting down dysthymic disorder.  I can see it being the case, but hadn’t heard of it before being combined with bipolar disorder.  Anyone else have it as a combo or know more about it?

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My doc thinks the dysthymia is the result of "sub-syndromal" symptoms of bipolar meanin they're there but not enough to count as a full blown episode 

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I doubt that your dr is diagnosing you w/both dysthymia and bipolar disorder at this point.  It’s much more likely that your dx has shifted from dysthymia to bipolar, as new/different symptoms emerged.  

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I agree you probably have s change in diagnosis, it’s basically what happened to me. I think I had poorly treated depression because I wasn’t be medicated for bipolar, the real issue. Maybe you will do better with new meds, too. 

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Absolutely, from dozens of ADs tried, to lamotrigine plus abilify. For me, it was life changing. Prior to that I was just told I’d probably be depressed forever. It’s almost worth dealing with the bipolar diagnosis which I hate since I am so much better. 

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That is a very good combo for BP...nice work by the doc to work with you and get it all (somewhat) settled 

@dancesintherain many bipolars are never symptom free and low level depression is definetly not super rare...I'm usually a bit on the crappy/lethargic side despite meds and therapy

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So I've changed psychiatrists since then, but as of my last bill from that psychiatrist, he kept both diagnoses...there was the billing code for dysthymic disorder and a billing code for bipolar disorder.  That said, what you said makes sense.  My med approach isn't drastically different in classes used (it was always mood stabilizer, AAP, and anti-anxiety), but it took four hospitalizations in the past 18 months.  One was for lithium toxicity, so that doesn't really count.  But two were for mania and one was for a mixed state. 

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