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What to do if I believe I do not have bipolar?


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Well, it's simple. My two psychologists greatly doubt I am bipolar. I saw one for three sessions and the other for 12 sessions (i.e., over 15 hours). They are competent and licensed psychologists. My psychiatrist believes I am. I saw him twice (i.e. two hours). However, I also doubt his diagnosis. I know I don't perfectly feel well, but I could put the blame for my depressions and most of my anxiety on university.

 

What should I do? Should I ask my pdoc to lower my meds and see? What should someone do in this situation?

Thank you,

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Many mental illnesses present in your late teens and early 20s, making college a prime time to present with a mental illness. That's when I first got severely depressed for two years (freshman and sophomore), than hypo for a year and a half (junior and first half of senior), then depressed for my final semester.

 unchallenged.

 

And I don't know if this is still true, but at least from the 1970s through the 1990s, pdocs and tdocs felt like they were in competition. *If* that is still true, you can't really take a tdoc's word right off the bat. I hope I am wrong, and that with the new century came more cooperation between your pdoc and tdoc.

 

If it were me, I'd see that psychiatrist until you have seen him or her at least 15 hours. You have given your therapist that leeway. And you basically saw your pdoc and other tdoc for about the same length of time. That tdoc has no more information than your pdoc as to what is going on with you.

 

I don't want to say, "Yes, you definitely are mentally ill." But I do want to say this is not a fast process. I'm sure you have read how treatment can creep and crawl.

 

Good luck.

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Really the psychologists and the psychiatrist should,be talking to each other. Does your psychiatrist even know that the psychologists disagree? He may be interested in their opinion - it's collateral information. Diagnoses change all the time as clinicians learn more about you.

Your treatment team really should be a team - at least to some degree. They should be communicating, aware of what the other is doing and more or less in the same page. If that's not the case you might want to make changes.

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I guess I question everything from diagnosis to medication. My tdoc seems to doubt more by BP than my BPD diagnosis. At the same time, he told me I never, in all our 12 sessions, looked severely depressed. Something feels off. I don't feel medication actually helps that much. Medication is a financial burden too.

 

I live in Canada. Here, tdocs and pdocs don't work together. They're different entities. You can waive them a right to communicate between each other, but it's not used often or to the patient's benefit because they never seem to take what the other doctor says as important matter.  It's annoying. Keep in mind it's my personal experience, so it might not be the same elsewhere in Canada. I can't find other doctors, though. Psychiatrists are limited and see patients only when it's needed. And needed basically means when it's catastrophic. So, psychiatrists issue lists of recommendations to general practitioners whom follow them. Gps mostly follow a fiduciary model of care which means they trust patients to understand and take the decisions. Trust is important.

 

In other words, I'm utterly confused as to what I should do. Keep with these meds, or switch meds, or stop them. If I stop medication by myself, my gp might not trust me to make decisions anymore and force treatment on me, or even not treat me anymore. It's all about how I feel and I have great difficulty to know exactly how I actually feel. I was told Lamictal tends to make it difficult to access emotions. It might be what affects me right now.

 

I'm sorry for this blob of useless information leading nowhere. Thank you, for your input, though. It's appreciated.

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Well then if technically your GP is managing your meds, then I guess you have to talk to them about your confusion and hope they consult with whoever they need to consult with. Especially if unilaterally stopping Meds is going to cause problems. Which you should never do anyway.

It sounds like a crummy setup. It's hard to believe sometimes how bad the mental health treatment is around the world. You should not be forced to self-diagnose like this.

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At the same time, he told me I never, in all our 12 sessions, looked severely depressed.

 

This would piss me off because to me it would mean that he wasn't taking your word for it that you are severely depressed.  My guess is that you might not look severely depressed because you are on the meds.  If you were to go off meds maybe then you'd look depressed.  I hate when DRs judge based on what they see, rather than what the patient tells them.

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Looking back to last year, I do see some improvement from taking the meds, but it's far from being optimal. At the same time, I feel like I miss something I had. Maybe it is some kind of drive or interest in what I do or want to do or anything actually. It feels so distant right now that I wonder what I was doing then. I also feel that it was actually better. However, I clearly know it was not on many planes, but this previous thought that everything was better before cannot be discarded easily.

 

Also, needless to say I was pissed at my tdoc to tell me that I don't look depressed or that I have any issue with my mood, really. I guess it was not his plan, but he made me doubt that I actually have something. I know it's not what he meant, but it sounds as such. He said that maybe my meds are doing the work and that I should not stop taking them if this is the case. But now I wonder what would happen if I stop and nothing happens? Do I need them? It feels like this bipolar trope of, "Seem well, why take meds? Dump them all." I feel like none of the doctors I see actually know what's going on. I won't stop taking them, but it's on my mind. I was fine two years ago.

 

I should ask my gp to lower my Lamictal and see what happens. Or maybe give me more? I don't know. Next step if Lamictal does not seem to work it's Seroquel XR or Lithium. I don't have to justify myself if I say I don't want to be on either of them. The side-effects sound bad.

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I should ask my gp to lower my Lamictal and see what happens. Or maybe give me more? I don't know. Next step if Lamictal does not seem to work it's Seroquel XR or Lithium. I don't have to justify myself if I say I don't want to be on either of them. The side-effects sound bad.

 

Not everyone has side effects from those meds, other than what they are supposed to do.  Everyone is different, so if you were offered them and you tried them you might be pleasantly surprised with no to minimal side effects.

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