Different Doctors - Different Diagnosis

Doctor: I am disgusted and tired.  I have suffered my whole life with knowing that I was not "normal".  I will skip over my story to the "now".

I am on a two-year plan.  I have decided that if I cannot be well/normal,etc., I will not live past 30 years old.  (I am 28.)  I have visited two psychiatrists--one has diagnosed me Bipolar.  This doctor is not in-network.  Thus, I cannot afford to see him. My in-network doctor thinks that my problems are "all in my head".  This is what I was told at my last visit this week.  To him, if I don't hallucinate and if I DO sleep, then I am not bipolar.  I wanted to knock his skull in.  But, all I did was bawl. I want my problems over, or I will kill myself.  If I can't change the game, I will change the playing field.  Still, I believe there HAS to be a different way. Please suggest anything/everything.  I would like to live.  I would like to be normal and content.  I would like the "busy-ness" in my mind to stop.  And I would like the "why bother, I'll die anyway" moods to STOP.

Dear Julie -- 
You have so much company, you wouldn't believe it.  There are a lot of folks like you out there.  You describe two symptoms that could indeed be "bipolar" (though are not certainly so): the "busy-ness" in your mind ("hypomania"?) and the "why bother, I'll die anyway" ("depression"?).  

If you really only have one doctor you can access who is covered by your insurance, then you might want to work a second job for 2 weeks and pile up enough money to hire yourself a second opinion, and take that in writing back to the first doc' and say "this is what I want, and if you don't want to try it, I'll try to understand; I'm told I should go to the insurance provider and submit your opinion and my other two opinions, and request that they pay for another provider" (since now you'll have two opinions saying "bipolar" -- I'll bet -- and only the one saying otherwise; that might work).  

Finally, you could go to my site and print out the "Dear Doctor" letter and take it to the primary care doc' that your insurance covers and say that you just want a trial of lithium and a trial of Depakote and that if neither works, you'll do what your current psychiatrist says (psychotherapy?) (take the second opinion letter if you have it, or the evaluation by the first doctor who said you were bipolar, with a copy for the doctor's files).  The Dear Doc' letter explains that there are detailed instructions to help her/him do these trials of lithium and Depakote on the website (www.psycheducation.org).  

If that works, let me know -- it's a little tricky walking into a doc's office and saying "I want this treatment", but I tried to write the letter so it would help you do just that.  So some feedback would be helpful.  

Overall, the most important thing to know is that there are an awful lot of folks like you out there who are getting better and no longer feel as they once did, as you do now.  You mustn't give up now, not before trying a lot of the treatments that have helped so many others.  It's just a matter of figuring out how to get those treatments, and ultimately I'm sure you can figure out something.  Best of luck with the process. 

Dr. Phelps


Published March, 2001