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Is my psychiatrist wrong?


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Hey everyone, this is my first post in this forum so bear with me  ;)

 

I've been seeing the same doctor for about 3 years now, and she seems to be unsure of my diagnosis (she's quite young, I believe I'm her first confusing patient lol). Anyways, I figure it'd be best to give some background information before I jump into things.

My first episode was when I was 8 years old (I've been told that's fairly young to have a mood episode  :huh: ) and was a depression that lasted over a year brought on by moving cities. From then until I turned 17 I had numerous lengthy depressions which were not helped (in fact they were worsened) by being prescribed antidepressants. When I turned 17 I started to have psychosis with my depressions where I would see people following me, staring at me, judging me, etc. I could hear their thoughts about me, and they wanted me to kill myself. They spoke to me and said horrible things. By the time I turned 18 I couldn't deal with it anymore and tried to kill myself (obviously failed thankfully). I got diagnosed with bipolar disorder at that point in time and I'm not entirely sure why. Since then my diagnosis has been flip flopping between bipolar disorder (diagnosed by my current psychiatrist) and schizoaffective disorder depressive type (diagnosed by the local mood disorder clinic). The mood disorder clinic is adamant that I do not have bipolar but my psychiatrist is having none of it.

 

I don't think I've ever been manic or hypomanic. I believe that my normal personality is just outgoing and impulsive and it's just been masked by all this depression. I think to my psychiatrist when I'm well I look hypomanic because I'm jumping around and happy and doing things that other people view as odd but I think that's just who I am. She says I'm hypomanic and just can't see it.

Is that even possible?

 

When I think about it I think the mood disorder clinic is right and that I have schizoaffective disorder and that my psychiatrist is just labelling my stable normal self as hypomanic.

 

I'm looking for other people's opinions, I've tried talking to my psychiatrist about it but she's firm in her beliefs. What do you guys think? 

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For the most part they are, but the thing is I want to try another antidepressant to try and prevent more depressive episodes from occurring (I'm just getting out of one this week) but my psychiatrist refuses to prescribe me one stating that it is dangerous for an individual with bipolar.

This is basically why my psychiatrist and I argue, I want to try a different treatment method but she's against it because of her belief that I am in fact bipolar.

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I ditto notfred....it's more important to treat the symptoms then it is to be have the label. That said.....sometimes just for personal reasons we want to know what it is that we have. Sometimes knowing what the "label" is helps us to identify and understand what is happening to us. 

 

Yes....you can and most likely are hypomanic and don't know it. I never saw my "up" times as being manic until I was medicated and then looked back on those times. Medicated....I could clearly see how manic I was and I often wonder why no one else ever saw it and picked up on it. How did I go years being Bipolar and no one insist that I be seen by a pdoc. 

 

Maybe asking your pdoc why she doesn't agree with the clinic may help clear up some of you not trusting her dx of you. Talking to her about it and remember....she has been your pdoc for 3 years, she just may know you better than you think. 

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It is very possible to be hypomanic and not recognize it. That's part of the problem with having bipolar - lacking awareness of mood states.

 

How is your sleep? Eight hours a day more or less all week?

 

How easily do you lose patience?

 

How long can you sit quietly reading a book or watching TV or staring out a window without the impulse to get up and do something else?

 

If you were depressed a week ago and are now hopping around all animated, I'd explore your pdoc's conclusion before jumping back in with another antidepressant. Most people do not recover from depression like that.

 

ETA:

The other side of the schizoaffective question is whether you've been psychotic when actually enjoying life?

Edited by AnneMarie
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Do you mind saying what your are on?

Sometimes pdocs will prescribe lamicital as an anti depressant type medication for people with bipolar disorder. The rational being it's a mood stabiliser without the possible aggravating effects of a anti depressants. I think if theres any speculation that you might have bipolar disorder avoidance of anti depressants is probably a good thing. That said they are plenty of people with bipolar that do just fine on anti depressants. 

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Likeabowlof0ranges:

I'm currently only on Abilify and Clonazepam. I was on Lamictal once before but the side effects were so horrible that I couldn't take it anymore (I was so sick I couldn't even walk).

 

AnneMarie:

When I'm depressed I sleep for ages and ages and never feel rested, when I'm not depressed and feeling happy I tend to not sleep because I feel it's a waste of time and that there are other more important/pressing matters to attend to other than sleep.

I'm generally a very patient person but there are times where I do have a very short fuse with people.

I have trouble sitting still long enough to watch TV or read, I'd much rather be doing something active like playing with my dogs or going out with friends.

 

As far as being psychotic while enjoying life, it has happened before albeit a lot less often than when I'm depressed. I'd say it's only happened once or twice before.

 

Becks:

I never even thought to ask my psychiatrist what her reasoning was, and it's something I should do as it would surely help me understand where she's coming from. From reading your guys posts I think I might be more likely to agree with her now, I had no idea you could experience hypomania or even mania and not be aware of it. And you're right, she might know me better than I think she does and she more qualified to be making a diagnosis than I certainly am so maybe I should be giving her more benefit or the doubt.

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...when I'm not depressed and feeling happy I tend to not sleep because I feel it's a waste of time and that there are other more important/pressing matters to attend to other than sleep.

That is classic hypo/manic behavior.

 

Yes, as Becks suggested, talk to your pdoc about her reasons for the bipolar diagnosis. You need to understand.

 

FYI, Abilify has antidepressant properties. It is used like an antidepressant by some. It is used to augment antidepressants as well. You probably are covered as far as prophylactic goes, at least until you know it doesn't work.

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We can't tell you what you've got, but some of the indicators of hypomania include a tendency to sleep less, being outgoing / full of excess energy, positive mood, irritability. 

 

This is a reputable website, my old pdoc used to always refer to it.

 

http://www.blackdoginstitute.org.au/public/bipolardisorder/bipolardisorderexplained/maniahypomaniadefined.cfm#Principal

 

 

Also it's extremely easy to mistake mild hypomania for feeling good, to a extent at least. 

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prevent more depressive episodes from occurring (I'm just getting out of one this week) but my psychiatrist refuses to prescribe me one stating that it is dangerous for an individual with bipolar.

This is basically why my psychiatrist and I argue, I want to try a different treatment method but she's against it because of her belief that I am in fact bipolar.

 

 

Then stop arguing about your diagnosis and concentrate on this symptom, which is not being treated fully.

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there is a fine line between bipolar with psychosis and schizoaffective

I have seen a lot of people come here trying to figure out their diagnosis

and you can always find a pdoc with a different opinion

ultimately treating your symptoms is the most important thing

Edited by bpladybug
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Some pdocs are happy to prescribe anti-depressants to bipolar patients under careful monitoring (including one of my previous pdocs). It's not common though and your pdoc is obviously not one of them. There are many other medications which can help with depression - perhaps you could discuss them with your pdoc (as I doubt you're going to change her mind about it even if you are right).

Btw it is ABSOLUTELY possible to go through a hypomanic spell and be blissfully unaware of it. But as notfred said the best approach is to focus on the symptom you are trying to treat without worrying too much about your label - it's the easiest way to deal with the problem rather than tying yourself up in jargon.

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I also was completely unaware that I was hypomanic for 3 months, until I was medicated. Now I look back and understand why my friends and family were so confused and concerned about me (and irritated by me!). I am more prone to irritable hypomanias, but I'm currently coming off a euphoric one and even then, I was hypomanic for a week before i realized it. 

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I take anti-depressants, but only along with lamictal as a mood stabalizer. I would never JUST take an anti-depressant on its own (that has shown to actually increase my depression rather than help it). 

 

For about 3 years I was on nothing but antipsychotics (geodon, abilify, seroquel, risperidone) and anti-depressants (citalopram, wellbutrin, now viibryd) and they helped balance each other out, I think. 

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Thank you all for your replies, the information you've provided me has been quite useful in helping me.

I obviously came to the right place for advice  ^_^

I think I'll try to be more helpful to my psychiatrist than argumentative and then hopefully we'll both agree (like so many of you have said) that it's important we treat any symptoms and that whatever diagnosis we come up with isn't really all that important. Although from what you guys have been saying I'm beginning to think she's more right than I've been giving her credit for anyways and it's been me this whole time making things difficult not her  :closedeyes:

 

It's time for me to be more cooperative either way. Thanks guys!

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