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BP and other ..?


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I used to be surprised when I saw BP types listing several other dx's with their BP one. My very early dx's were insomnia, then depresssion, then GAD, then ADD, and I had the whole range of appropriate (that might be questionable) meds thrown at me. There were two suicide attempts while I was in the middle of all that and a few stays in drug rehab centres. Then along came an intelligent pdoc, and she pulled that all together into BP1 - ie each of what I listed above could pretty much be explained within the context of a manic phase, a mixed phase, a depressive phase, with a few interesting psychotic symptoms thrown in (now I sound like a cookery book). On one level it seems more efficient to have one dx. - for cases like being hospitalised - for whatever purpose - you don't have to try to explain each dx to someone who hasn't a clue what you're talking about.

So I'd like to know everyone's theory on this. Was it ever explained to you why you have, for example, a GAD dx along with a BP1 dx? Does it have to do with panic attacks (which I suffer too)? Out of my own list above I reckon that the insomnia, depression, opiate abuse and generalised irritability and anxiety DO slot into my BP (as do the suicide attempts), but the one I'm not convinced does is ADD. I was on ritalin for nearly 2.5 years and it HELPED. My concentration was better than ever before and I was extremely productive at work. On the other hand, my pdoc would probably counter that with saying that I can concentrate now b/c of the BP cocktail. (Answer to that: well actually I don't concentrate at any level remotely resembling the one when I was on ritalin.

For some reason this is just going round and oun inside my head. I really don't need or want more meds; I swallow a pharmacy four times a day.

I'm also NOT seeking an additional dx (no bloody way)... would just like to know your thoughts on comorbid dx's.

Skittle

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I COULD probably be diagnosed with tons of stuff... OCD, GAD, panic disorder, dysthymia (I've had that one) or BPD (that one too)... But my pdoc thinks these are all a part of the bipolar. I agree. Seems pointless to me to have multiple diagnoses, when it works to treat the bipolar only. Ok, except the BPD tendencies, something I have to work on myself or in therapy.

Then I have ADHD, something that's definately something else. I can't be treated for that right now, since it messes with bipolar symptoms, but when I am stable my focus is better. Not good, but better.

And psychotic symptoms... I brought those upon myself.

But in general, I think many peoples multiple diagnoses can be explained by BP only. Treating BP should be the number one priority, since that usually improves other symptoms as well.

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But in general, I think many peoples multiple diagnoses can be explained by BP only. Treating BP should be the number one priority, since that usually improves other symptoms as well.

thanks Helena - that's pretty much exactly what I was trying to say (only in a very round about don't-want-to-tread-on-any-toes way)

S

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Hiya Skittle-

i can string all those various DXes after my name too, like Loon, BP1, PTSD, GAD, Insomnia, dysthymia (why do people think we have that?), depression, mania, hypomania, psychosis, schizoaffective disorder, bp2 (yep, that one too), bpd issues (not full-blown disorder), the list goes on. also ADD like you.

Like you, the ADD isn't mixed with the BP, it is on its own. it isn't being addressed with meds right now because it would mess with the bp cocktail. my pnurse and pdoc think that my ADD is a part of the BP and i disagree entirely, and can disagree until the cows come home and they don't believe me. such is life. i wasn't helped by strattera so that was the last of their attempts to help with that.

i don't even bother to tell anyone that i have GAD because it is kind of obvious by the fact that i have BP and also PTSD that there could be some GAD going on, and that i take klonopin. the insomnia is a part of the anxiety issues and comes from bp as well.

see, the BP DX is so much better and more descriptive. i read that in the next DSM they're going to use MODERN IMAGING RESEARCH to show how BP isn't just a brain disorder, but it is a system-wide disorder that messes with several of our body systems. So you have many bp people wtih neurological conditions, diabetes, and so on. it won't be "just" a mental disorder anymore. at least, that's what i'm reading.

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Just to clarify, so nobody gets pissed off...

Of course there can sometimes be a point of multiple diagnoses, if you really do feel like your other problems aren't related to BP. Sometimes you might need to treat other symptoms too.

But in most cases, I stand by what I said.

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I agree that BP should be the first DX to tackle because it is pervasive...it hits so many systems and affects so many parts of our lives...to get the BP issues straight first seems obvious.

I know that my BP was the reason for my alcohol issues and my insomnia and it is the reason for my intermittent psychotic issues and it is probably behind my generalized anxiety (though much of my social anxiety can be chalked up to my Asperger Syndrome). So yeah, why string all of those letters behind my name? Let's keep things simple, right?

I do list my anxiety separately here on CB because I like to put it out there to fellow anxiety sufferers as a little point of solidarity, I guess. Anxiety can make us feel so isolated and I guess it's my little white flag or my peace sign or whatever saying, Hi, yeah, I'm one of your kind, I'm safe, I feel like you do, scared out of my wits, too.

But my pdoc pleasantly folds my anxiety in with my BP, along with my old alcohol problems (2 yrs sober--yay), my insomnia, my heebie jeebies, my difficulty concentrating (never been called ADD, I'm a compulsive attender when not manic, probably due to the Asperger's again), my suicidal tendencies, my self-destructiveness, etc etc, what have you...yes yes, all of it, why talk of it all separately, why medicate it separately, it all seems neatly dealt with under the BP umbrella.

I think, for me, it comes mostly down to meds. BP is a medical phenomenon, at its purest. Get the meds right and you're well more than half the way there. Get your sleep right and you're in the home stretch. Get your therapy going and you're...well, you're talking, anyway. I don't know...I hate therapy...don't listen to me there. But you get the idea.

Interesting thoughts, Skittle.

~Cat

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