Jump to content
CrazyBoards.org

upset w/p-doc


Recommended Posts

I found out today from my therapist that my p-doc has me listed as "possible bi-polar". I am really angry I guess b/c I live currently in a small town, I used to see my p-doc for depression and anxiety treatment, and then I moved to a big city and the shit really hit the fan. I had a really severe manic episode that lasted at least two months. Every dr. that saw me agreed that I was BP type I with psychotic features. Some even thought I was schizophrenic when I was first admitted. My p-doc now that I've moved back to my shitty small town apparently has doubts about whether the episode was "triggered by medication" but I had been on the same meds for like 5 years without incident. Also, my first serious manifestations happened about a week or so after I quit taking all my meds. It just makes me feel like what I experienced isn't valid or important. That it is something easily explainable and easily dismissed.  I don't know why, but the diagnosis of the "big city" dr's gave me some hope b/c I at least had a name for what happened. My current p-doc does not seem to understand how severe my symptoms were. I hate it here. Healthcare in general sucks, and the psychiatric people employed by the county tend to be effing idiots. Sorry, I just had to get that off my chest.

Link to comment
Share on other sites

I can sort of see why your pdoc would hedge his bets. If you didn't experience those symptoms until coming off all your meds suddenly the it could very well be medication related. Going cold turkey on psych meds can have disastrous side effects. Anyhow, the best advice I can give is not to get hung up on the diagnosis - what's important is controlling your symptoms and your quality of life. If you have a therapist they could probably help you work on that, I think many people struggle with it on and off.

Link to comment
Share on other sites

It just makes me feel like what I experienced isn't valid or important.

Would you consider telling your pdoc this? If you feel you're not being listened to about the severity of your symptoms--regardless of what the correct label for those symptoms is--your doc needs to know. I agree with helloheartbreak and bpladybug that the important thing is to focus on treatment of your symptoms; the diagnostic label is really just a guideline and labels tend to change, anyway. So if you're worried about breakthrough mania, I would hope you'll be able to communicate that to your pdoc, and that your pdoc listens to you. At the very least, if your pdoc suspects your prior manic episodes were triggered by something external to your diagnosis, you can ask your pdoc to explain their rationale so you know whether your experiences have been taken into due consideration.

Communication is so important with pdocs! I struggle with telling my pdoc everything he needs to know, sometimes, because I have it in my head that he's not here for "touchy-feely stuff;" but if that were true, I suppose he wouldn't be treating people with mood disorders. 

Link to comment
Share on other sites

Does it really matter what they call it?  It certainly doesn't to me.  If you've got meds that are working then I'd not care.  Besides, a lot of the meds are the same.  

 

It might be that your pdoc is using the word possible so that you don't get a BP diagnosis that my potentially follow you around for the remainder of your life.  I've had pdocs like that in the past.  They'd give me the least severe diagnosis that would get me the treatment that I needed.  You should talk to your pdoc about the diagnosis.  Keeping the lines of communication open between you and all your healthcare providers is vital.  

Link to comment
Share on other sites

I found out today from my therapist that my p-doc has me listed as "possible bi-polar". I am really angry I guess b/c I live currently in a small town, I used to see my p-doc for depression and anxiety treatment,

 

To me, this is why a correct diagnosis matters.  If the OP is simply treated for depression, then appleblossom may be given an AD without a mood stabilizer (though not her current situation, as indicated by the seroquel).  Most of the drugs are the same, and yes, they're used to treat symptoms, not a diagnosis, but it's pretty established that ADs can rocket bipolars into mania, especially if there's not a presence of lithium, an anti-convulsant, or an AAP.

 

When I was younger, I had the exact same thing happen.  I was diagnosed (and treated) for MDD, which simply meant I was put on an AD.  I rocketed in to mania, but for years it went undiagnosed because I thought my (hypo)manias were just how normal people felt all of the time.  I only went to a doctor when I was "depressed".

 

I agree with bpladybug about getting your records transferred.

 

If your doctor is listing bipolar as a possibility, then I would assume that he/she has not ruled it out completely (and helloheartbreak is right, imo, about your doctor "hedging bets" since you'd just come off your medication).  Especially if you just started seeing this pdoc (albeit again), she/he just might not have had enough time to form his/her own opinion based on what he/she has observed from you.  I have had doctors who simply took me at my word, and I have had doctors who wanted to form their own opinion(s) over a period of time.

 

If you display obvious symptoms, and your doctor does not see them, then yes, there should be some cause for concern.  Otherwise, I'd focus on making sure your medications are controlling your symptoms, no matter the label.

Link to comment
Share on other sites

I guess I am being petty about the diagnoses. As long as my p-doc continues to help me treat the symptoms, I should be grateful. It just irks me still that dr's and psychiatrists in a more advanced part of my state all agreed on my diagnoses. It is also hard b/c I can't work and a BP diagnoses is more convincing t the SSI people than a "dunno?" diagnoses.

Link to comment
Share on other sites

I found out today from my therapist that my p-doc has me listed as "possible bi-polar". I am really angry I guess b/c I live currently in a small town, I used to see my p-doc for depression and anxiety treatment,

 

To me, this is why a correct diagnosis matters.  If the OP is simply treated for depression, then appleblossom may be given an AD without a mood stabilizer (though not her current situation, as indicated by the seroquel).  Most of the drugs are the same, and yes, they're used to treat symptoms, not a diagnosis, but it's pretty established that ADs can rocket bipolars into mania, especially if there's not a presence of lithium, an anti-convulsant, or an AAP.

The key word being CAN.  I'm BP I.  Have been for decades.  I am currently on one med from the pdoc.  Amitriptyline.  That is all.  It is a TCA and most certainly, an AD.  Does the fact that I am currently only on amitriptyline mean I'm not BP I?  Certainly not.  There is no cure for BP.  You treat symptoms.    

Link to comment
Share on other sites

 Most of the drugs are the same, and yes, they're used to treat symptoms, not a diagnosis

 

That is exactly why I said this.

 

My point is that the drugs may not change at all, but your doctor knows to look for symptoms of (hypo)mania if you're only on an AD.  If you have a MDD diagnosis, and you suddenly have more energy, sociability, etc., it's not always obvious (at least at first) that it may actually be causing undesirable behavior.  In my case, it looked like the ADs were working on my depression, and then I was "fixed".  Treatment was discontinued because they (and I) thought there wasn't anything left to treat.  By the time I was in a full hypomanic state, there were no doctors around to note my behavioral changes.  My depression was simply thought to be "situational", and once I started acting better, then I was "fine".  It took years of repeated doctor's visits and therapy for someone to notice there was a cycle.  I'm not the only person here with that kind of story.

 

Like I said, I've been on only ADs for most of my life (now, I'm only on Xanax--I nowhere implied that I was somehow not bipolar any more because I was not on "bipolar" medications).  Not all ADs have caused mania for me.  Now that I have an accurate diagnosis, however, I am aware of the possibility.  Almost everyone here uses medications for off-label indications in some form or another.  I have no issue with that.  My only point was if a doctor seems to be stuck on a particular diagnosis (to which I said:  "If your doctor is listing bipolar as a possibility, then I would assume that he/she has not ruled it out completely") it's easy to miss other symptoms that may clarify or alter a diagnosis and the meds used to treat it. 

 

How many people here have started with MDD, then gone to some form of Bipolar, and then an SZA diagnosis? Did they all change their medications with each change of their diagnosis?  No.  Or some people started with BP only to realize that there are also OCD traits?  In those cases, some doctors may elect to use Luvox (for example) because it's been shown to be helpful in controlling OCD and depression.  A good personal example for me was the fact that I had a lot of anxiety and high blood pressure.  Knowing both of those things, my doctor opted to put me on propranolol because the side-effect profile for a beta-blocker can help with anxiety.  It was a miracle drug for me.

 

Otherwise, I'd focus on making sure your medications are controlling your symptoms, no matter the label.

 

Again, I'll reiterate since I apparently wasn't clear enough.  If your symptoms are being controlled by the medication you take, then there's no reason to get hung up on a diagnosis. In this particular case, if the OP believes she's bipolar (and has previously been diagnosed by multiple doctors as having bipolar), it's important to watch for the symptoms of bipolar.

 

Back to the OP's problem, however:

It is also hard b/c I can't work and a BP diagnoses is more convincing t the SSI people than a "dunno?" diagnoses.

To my understanding, it's not your job to convince the SSI people that you have one particular form of MI than another.  Even if your doctor decides that you have a MDD diagnosis and you can't work, that's not much different than having a Bipolar diagnosis and can't work.  Social Security tends to focus on what symptoms you have that keep you from working. For insurance and SS reasons, the doctor will probably be forced in to labeling you with a diagnosis or some sort, but what will be taken into consideration is what you're not able to do that keeps you from working.  Also, when/if you apply for SSI, they will probably want ALL of your medical records (or as much as possible) to make their determination.  That will most likely include not just your current doctor's notes/reports, but your previous doctors' assessments as well.

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...