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Not sure of Diagnosis


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Hello all,

i was sent to the hospital a month back because I mixed alcohol with xanax and had suicidal thoughts/plans and scared the crap out of my wife. While in the hospital, the Dr. told me I was Bipolar and prescribed me Seroquel 200mg and Tegretol 200mg and took me off of Lexapro (which according to her made things worse) and xanax and klonopin. I never felt like I had a major manic episode. I have had problems with drinking/spending too much and bad decisions. However, I have never been up for 2-3 nights in a row or anything like that. I am wondering if the Dr. could have got it wrong. I have always dealt with anxiety/depression, and the Seroquel seems to slow down my thoughts and help me sleep at night. I just wonder what you all think being that you have experience in these areas.

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Hi. Bipolar II does not require a major manic episode. Hypomania includes the same symptoms but is less extreme. Bipolar II can also look like anxious depression. Psycheducation gives a fairly good description of how Bipolar II presents for some.

I think it reasonable to question a diagnosis given under the worst of circumstances, but it may be perfectly accurate. If I was you, I would ask my GP for a referral to a psychiatrist or psychologist for a full assessment. If you have bipolar, you will need treatment, so the psychiatrist is the better option, IMO.

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Thanks Stacia,

I am seeing a Nurse Practitioner that is helping with meds, she wonders too. Thank you for your imput.

Hi. Bipolar II does not require a major manic episode. Hypomania includes the same symptoms but is less extreme. Bipolar II can also look like anxious depression. Psycheducation gives a fairly good description of how Bipolar II presents for some.

I think it reasonable to question a diagnosis given under the worst of circumstances, but it may be perfectly accurate. If I was you, I would ask my GP for a referral to a psychiatrist or psychologist for a full assessment. If you have bipolar, you will need treatment, so the psychiatrist is the better option, IMO.

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I've never been manic or even hypomanic and my current working diagnosis is BP II, see my signature below. However, I've had five episodes of major depression, some lasting for a few years at a time, and I can relate to the suicidal thoughts. A lot of people think that mania involves euphoria and personal messages from god, but that's the exception, not the rule.

At any rate, a diagnosis is a guide for treatment, and as you'll see from hanging around here, it's not unusual to have it change over time. The main thing is to get your symptoms under control. But being suicidal is a pretty clear indication that you have some flavor of mental illness that will probably be helped by medication, and may get a lot worse if left unmedicated.

A nurse practictioner is fine in the short term, but as others have mentioned, a full psychiatric evaluation is in order. The initial visit should last 1 to 1.5 hours and the psychiatrist will take a full history and be able to determine what the best course of treatment will be. They may also recommend therapy with a psychologist. Most psychiatrists (pdocs) these days do medication management only, and if you need talk therapy, then you'll be seeing a therapist/psychologist (tdoc). Tdocs can't prescribe medication. You can often find them both in the same medical practice.

Also, there are lots of medications available these days, and they affect everyone differently, so try to keep an open mind about things. It sucks to find out you have a mental illness and need treatment, but it's not the end of the world, and many of us are indistinguishable from everyone else. I have a good job, good friends, hobbies, and all the trappings of a regular life, I just take meds every day to keep it that way. Good luck to you.

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Actually, a psych. NP is fine in the long term as well. In addition to their nursing degrees, NP's have either masters or doctoral degreesmin their specialty areas. They are both trained amd licensed to do pretty much everything anpsychiatrist can do - diagnose, evaluate, prescribe, manage care, and hospitalize. Stattes differ as the the amount of supervision they require, but in most places, they are able to act pretty independently.

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