Am I not entitled to know?

[nnxt]

I've been obsessing over my dx of BPII as usual. I know I should stop and just concentrate on getting better. Various docs have slapped this dx on me like I'm prime, grade A, and ripe. I still have lingering doubting thoughts about it.

I do have intensef mania when taking certain ADs. I just can't remember if I've ever had it without meds. I would be on the depression end of the spectrum if BPII is the case. Anxiety is also a major problem for me.

Recently I got on a plane and just flew well really far away to meet a roommate from the internet. It was all of a sudden and I was not on any meds. Iss it really mania though? I did go to the nuthouse twice there where once again the dx is given.

I know I should stop obsessing!!, but...

Am I not entitled to know if I really have it? How can I be sure when psychiatry isn't an exact science?

[Sam]

Hey!

I would say that you are entitled to know if you really have BPII, but it sounds like several doctors have told you that you have it.

The fact that I freaked out on SSRIs was a BIG CLUE to me that I was BP. Anxiety can be a sort of mixed or dysphoric state. I was horribly anxious when I was just on SSRIs. It was a nightmare.

Psychiatry is NOT an exact science. But you know there are guidelines. If you fit the guidelines, then they will dx you as best as they can based on the evidence. Have you been on mood stabilizers and if so, have they helped with your depression?

It sounds to me like you have plenty of evidence that points to a BPII dx. I am thinking you just don't want to accept it. You need to determine why that is. It is possible that your non-acceptance could lead to being non-compliant with your meds. I say don't worry about the dx, just see if you feel better on the meds. Sometimes that gives you a whole new perspective.

Hope you feel better.

Sam

[wifezilla]

BP comes in many flavors. Mania can be in the form of anxiety.

Will having an exact label change your treatment?

Is focusing on whether or not you really have BP a way for you to avoid dealing with the realities of ANY type of BP diagnosis?

[AirMarshall]

NNXT,

When multiple doctors give you the same dx, that is a Clue.

Denying, or having a hard time accepting the BP illness is so common amoung BP'ers, that it has its own term "Lack of insight to illness" and is listed as one of the symptoms of BP.    Probably the only illness in the DSM-IV that has that symptom.

In the end, focus not on the diagnosis but on getting the right med mix and on controlling your symptoms.

If you haven't got it already, go borrow or read  The Bipolar Disorder Survival Guide bye Miklowitz. http://www.amazon.com/gp/product/157230525...5Fencoding=UTF8

  It it the single best book on BP. 

Hang in there.  Trust your Pdoc, see your Pdoc regularly and tell him how you are really feeling.

A.M.

[ncc1701]

Heya nnxt,

I second AM's endorsement of BPSG.  I carry it everywhere actually.

And the current thinking among a lot of psychs is that many, many things are bipolar until proven otherwise:

-- medication-induced hypo/mania/mixed

-- atypical depression

-- treatment-resistant depression (I had this.  SSRIs were like water, very fattening water)

-- depression in someone with a bipolar relative

-- cyclical moods, like SAD and PMDD

-- old people with a late-life dx of schizophrenia, esp up to about 15-20 years ago

(I had the top 5, incidentally (going to these talks can be really, really weird for me, as I have to make damn sure to eat the free cookies so I have my mouth full and thus don't jump up and yell, Yes!  Yes!  *That's* what I've been trying to say!), and my aunt and my grampa likely had the late-life one.)

This is NOT DSM stuff, maybe in the future, but who cares.

It's a guide to treatment, so more people get trials of mood-stabilizers and not just a bunch of antidepressants.

Like Sam said, psych likes to think it's science, but it's a long ways off.  A lot of descriptions, categories, correlations, and trial and error.

Which after all is what we used to do with infectious diseases.

I agree with the wife that although it's interesting (and *can* be useful) to cram yourself into a box in DSM, worrying too much over it can for sure cloud your ability to move forward with treatment.

I admit I obsessed over it for a long time, trying to find a box that fit every last one of my symptoms.  Which was mostly a fun way to delay diagnosis and treatment, b/c I for sure did *not* want to be bipolar, and wanted to be wrong about my dx.

At any rate.

Certainly reading a lot of people's stories around here has helped me to (mostly) quit DSM'ing myself.  Mostly.

--ncc--

[celestia]

Heya nnxt,

I second AM's endorsement of BPSG.  I carry it everywhere actually.

And the current thinking among a lot of psychs is that many, many things are bipolar until proven otherwise:

-- medication-induced hypo/mania/mixed

-- atypical depression

-- treatment-resistant depression (I had this.  SSRIs were like water, very fattening water)

-- depression in someone with a bipolar relative

-- cyclical moods, like SAD and PMDD

-- old people with a late-life dx of schizophrenia, esp up to about 15-20 years ago

How ironic, nnxt, I am having difficulty getting my pdoc to consider that I might be BPII.

My tdoc is on board, so it's not like I'm going off half cocked. Because I am one of those paranoid spaz types that can get whatever I read about. But it usually passes.

Briefly, I've dx'ed dysthymic (sp?) all my life, SSRIs don't make me bat shit, and they do work for while, but not as well as SSNRIs, which is what I take now, Cymbalta.

However, last summer, my suicidal ideation that has plagued me off and on for 30 years, became full on, full blown I was gonna do it. I was despondent for a long period of time and the only thing I did right during the whole of 2003-2005 was continue to see tdoc.

But I wasn't getting better, and one day, I showed up in my pajamas after 7 days since a shower and just looked at him with dead eyes and said, "I don't think I can fight this anymore." My plan was all elaborate and ready to launch so the kids would not know it was suicide, I mean I was *there*.

Fast forward, I'm much better. But I'm still depressed as fuck and moody as hell! Mood swings without mania.  Pdoc just shakes his head. He thinks it's just SAD and wants to see how I do over the summer. And as long as I'm stable that's cool, but like I said to tdoc, "I feel grateful to be dysthymic again." He thought that was fucked up. He said, "you should feel a lot better than that." I agree, but I'm still glad as hell I'm not in that pit I was last summer.

Other things too, pointing toward this dx for me. In fact, Air Marshall has great links pinned at the top of this forum...check 'em out.

I don't WANT a more complex dx, or more meds, I just want to be functional and feel some amount of peace, contentment and pleasure. And it's not like I have a zero factor in these areas, but life is a slog through jello or toxic sludge most days. It's hard. <psssttt. It makes me want to get and stay wasted...sound familiar?>

Stay with us, don't give up.

S9

[Loon-A-TiK]

nnxt,

my BP parents decided when i was a kid and DXed that i'd do better on no meds, with just their "great" parenting. The results showed in so many ways, including the highs and lows on my report cards and social functioning.

Your treatment, like others have pointed out, is the main thing. Your DX is important just as a guideline for RX. They kind of go hand in hand a bit. right now, my line-up is heavily anti-depressive and anti-mixed. in the past i've been batshit manic for months at a time. all in due season.

just believe your treatment professionals. they are the ones you pay to help you. and believe your instincts. you know you cycle. how far do you cycle? you may not really remember. your friends and family may be able to shed more light on if you were ever more productive in an odd way, or overly friendly in an odd way, or whatever hypo would be for you (these are common ways it shows up).

Dysthymia and MDD at the very least.